Three-month-old Joey Powling is the latest Internet meme, thanks to his cool smirk just five days after open-heart surgery.
The baby best known to the world as "Ridiculously Good-Looking Surgery Baby" was born with tetralogy of Fallot, a heart defect that hampered blood flow to his lungs.
"The lower ventricles didn't grow and connect, leaving a little hole there," said, Joey's dad, Joe Powling, who found about the defect when his wife was 24 weeks pregnant. "It was kind of nerve-wracking."
Because the lungs keep the blood rich with oxygen, babies with tetralogy of Fallot need early surgery to correct the problem.
"The long term risk of arrhythmias is lower, and the function of the heart is much better if the repair is done earlier," said Dr. Christopher Snyder, chief of pediatric cardiology at Rainbow Babies and Children's Hospital in Cleveland.
On Oct. 25, the Powlings held their breath during the 7-hour procedure.
"It felt like forever," said Joe Powling. "You have no control over the situation. There's really nothing you can do."
The surgery to repair tetralogy of Fallot has been around since the 1960s, according to Snyder.
"It's the first heart defect that we were actually able to fix," he said, adding that the prognosis after surgery is good. "There is no simple cardiovascular surgery, but this repair's been going on for a long time."
Joey's surgery went well, but he was hooked up to a ventilator for two more days, according to his dad.
"He was still intubated and had about 15 different lines and tubes into him," said Joe Powling. "But by the fifth day he was back to himself."
That's when the Powlings snapped the now-famous photo, which, with more than 1.6 million likes on Facebook, has been transformed into a string of Internet memes like, "If Chuck Norris had a baby, he'd almost be as tough as this."
"That one's my favorite," Joe Powling said, noting his baby's knowing grin. "He'll usually give you a little smirk like that."
But Joey's not out of the woods yet. He might need a second round of surgery in a year, according to his father.
In the meantime, the Powlings are using their Internet fame to raise awareness about tetralogy of Fallot.
"So many children are born with congenital heart disease, and the world needs to know that it is common and it can be treated," they said on their website, JoeyHeartsYou.com. "With the proper medical attention, many children can grow up to live normal lives. Joey wants you to know that it will be okay."