The twin girls joined at the head: Sisters share a skull but have their own brains and 'very different personalities'

Twin girls who are joined at the head may soon be separated in a life-changing operation.

The sisters, Nadira Alifa Putri and Nadiba Aisyah Putri, have been conjoined since their birth four months ago, sharing a skull but not a brain.

They were born on January 21 as triplets, delivered by Caesarean section at the Tanjungpinang Regional General Hospital in Indonesia, but their other sister is separate to them.

Parents Siti Nuryaningsih and Juarnes Prana Dinata, both 30, are now waiting for a landmark operation which will separate their daughters, allowing them to lead a normal life.

Mr Dinata said: 'The doctors were shocked at birth when they realised it was a triplet and a conjoined twin as well.

'I am glad that all the babies are healthy but I am really looking forward to their separation.

'It is really difficult for me and my wife to see them like that.'

Their mother says they may share a skull, but they have completely separate characters.

She said: 'Both of them have completely different personalities.

'They are too young to make decisions but they know what they want to do in that moment.

The surgical separation of conjoined twins is a delicate and risky procedure, requiring extreme precision and care.

Therefore, the decision to separate twins is a serious one.

Mortality rates for twins who undergo separation vary, depending on their type of connection, and the organs they share.

In cases of twins where the pumping chambers of their hearts are conjoined hearts,  there are no known survivors.

Although success rates have improved over the years, surgical separation is still rare.

Since 1950, at least one twin has survived separation about 75 per cent of the time.

It is only after twins are born that doctors can use magnetic resonance imaging, ultrasound and angiography to find out what organs the twins share. In order to determine the feasibility of separation, doctors must carefully assess how the twins' shared organs function.

After separation, most twins need intensive rehabilitation because of the malformation and position of their spines.

The muscles in their backs are constantly being flexed and they often have a difficult time bending their backs forward and backwards and sitting up straight.

'So we think attempting a separation surgery is a step that needs to be taken.

She added: 'When one sleeps the other one wants to play so their sense of doing things is really messed up.

'We are really looking forward to their separation.'

The twins have been referred to the Cipto Mangunkusumo Hospital in Jakarta.

But doctors at the hospital have asked the parents to wait until the babies gain weight to perform the the operation to split them up.

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