A mum with a facial condition is teaching her four adopted sons to "ask questions but be kind". Hannah Vaughn Setzer, 32, was born with cystic hygroma - a condition where multiple cysts grow - which has left her with “’literally thousands” of them in her head and neck. During one of her many surgeries after birth, she claims doctors were scooping handfuls of cysts out of her head when they accidentally removed some of her facial nerves – leaving her unable to smile. She was fitted with a feeding tube and a breathing tube as a newborn and defied medics by flourishing, changing her tube independently as a teenager and brushing off cruel comments from strangers. Disability rights advocate Hannah has defied the odds - turning to health and fitness in adulthood - and blogs her journey under the moniker Feeding Tube Fitness. Now, Hannah has adopted four children - two sets of brothers aged 11, 12, 14 and 15. She says how she's teaching her boys "it's OK to ask questions" but they have to "be kind". Hannah, a business owner, from Richmond, Virginia, US, said: "It was definitely a long process, to have the boys as part of our family, I am grateful for the opportunity to have them into my home - we are just so happy." "A lot has changed in my life. My husband and I have adopted four children. "Their foster parents asked if we were adopting and of course, we said yes." Hannah said the adoption process took around a year - starting in 2021. She said: "They were in our home for about a year before we could even start the adoption process. "There is lots of paperwork and things like that and we were just so happy to be able to adopt." Hannah said that she and husband, Brandon, 33, a business owner, have always wanted to adopt. She said: "We knew that we wanted to be foster parents, we started the process in 2019 and we never anticipated adopting, especially adopting four children in two years. "They are really so happy, we really love these boys and we are happy to give them a home." Disability rights advocate Hannah is passionate about educating people on her condition. She said: "I am very honest about my disabilities. "I never wanted to make them feel uncomfortable, we have always been very upfront and honest and we told them that they can ask me anything. "I never wanted them to feel uncomfortable about anything and they are all very patient, kind and accepting. "We have definitely had lots of conversations about being kind and respectful to everyone. "They are so great with it and very patient, they were all curious at first and that is OK. "We just try to have open and honest conversations about how everyone is different and this is what is different about me." Hannah and Brandon both said that they would love to adopt more children in the future. She said: "There are always kids that need good homes and we have a good home so we are always open to sharing that with whoever needs it."