Prichard Colón’s face changed because a severe brain injury left him in a persistent vegetative state, causing widespread muscle wasting throughout his body, including his face. The undefeated Puerto Rican boxer suffered a brain bleed during an October 2015 fight that required emergency surgery and left him unable to move, speak, or control his facial muscles. Years of immobility have fundamentally altered his appearance.
What Happened During the 2015 Fight
During a welterweight bout against Terrel Williams on October 17, 2015, Colón absorbed repeated illegal blows to the back of his head. Despite complaints from his corner, the fight continued. By the later rounds, Colón was visibly deteriorating, but he finished the fight. Shortly after, he collapsed and was rushed to the hospital by ambulance.
Doctors diagnosed him with a left-sided subdural hematoma, a dangerous collection of blood between the brain and skull, measuring 1.5 cm in diameter with 1.2 cm of midline shift. That midline shift means the bleeding was severe enough to physically push his brain to one side inside his skull. Surgeons performed an emergency hemicraniectomy, temporarily removing a portion of his skull to relieve the pressure and drain the blood. Despite the surgery, the damage to his brain was catastrophic. He was 24 years old.
How Brain Injury Causes Facial Changes
When people see recent photos or videos of Colón and compare them to his boxing days, the difference is striking. His face appears thinner, less defined, and lacking the muscular tone it once had. This comes down to two related processes that happen when the brain can no longer send normal signals to the body’s muscles.
The first is simple disuse. Muscles need regular use to maintain their size and structure. When someone is bedridden or unable to move for extended periods, the body breaks down muscle protein it no longer needs. This is called physiologic atrophy, and it affects every muscle in the body, including the small muscles of the face that control expression, chewing, and movement. Colón has been in a minimally responsive state for years, meaning these muscles have gone largely unused.
The second process is neurogenic atrophy, which is more severe. When brain damage disrupts the nerve signals that connect to muscles, those muscles don’t just shrink from lack of use. They can lose their nerve supply entirely and waste away more rapidly and extensively. Research in neurotrauma has shown that traumatic brain injury causes secondary changes in tissues far from the brain itself, driven by altered motor signals and loss of the normal electrical activity that keeps muscles healthy. Animal studies of TBI have documented significant decreases in muscle fiber size, with the body actively breaking down contractile protein through its internal recycling systems.
In Colón’s case, both processes are likely at work. His brain injury was severe enough to leave him in a vegetative state, meaning the motor pathways that would normally keep facial muscles active and toned are profoundly disrupted. Over months and years, this leads to visible thinning and flattening of the face.
The Skull Surgery Itself Plays a Role
The hemicraniectomy Colón underwent also contributes to his changed appearance. This procedure involves removing a section of the skull to give a swelling brain room to expand without being crushed. In some cases, the bone is replaced later. But even after reconstruction, the shape of the head and the way soft tissue sits over the skull can look noticeably different. Combined with the loss of facial muscle mass, this surgical alteration changes the overall geometry of the face and head in ways that are immediately visible.
Why the Change Is So Dramatic in Colón’s Case
What makes Colón’s transformation especially jarring is the contrast with who he was before. As a professional boxer, he was an elite athlete with exceptionally well-developed musculature, low body fat, and a strong, angular face. Boxers carry significant muscle mass in their jaw, neck, and face from years of training. When all of that muscle wastes away over years of immobility, the visual difference is far more dramatic than it would be for someone who started with an average build.
Weight loss also plays a role. Patients in vegetative or minimally conscious states receive nutrition through feeding tubes, which typically provides enough calories to sustain life but not the surplus an athlete’s body once used to maintain its size. The loss of both fat and muscle tissue across the face, combined with the effects of aging without normal movement, creates a cumulative change that deepens with each passing year.
Colón’s family has shared updates on social media over the years, and those who follow his story have watched these changes progress gradually. His mother, Nieves Colón, has been his primary caregiver. While some improvements in responsiveness have been reported, including signs of awareness and limited reactions, his physical condition reflects the reality of long-term severe brain injury. The face people remember from his boxing career belonged to a healthy, muscular young man at his physical peak. The face they see now reflects what happens when the brain can no longer maintain the body it once controlled.