Tillman (pictured) is also a twin but they were not affected physical by the birth defect.
A California woman who doesn't have the use of her hands or arms has become a prolific artist - by painting with her mouth and feet.
Alana Ciena Tillman was born with a rare disease that has left her unable to contract or move some her joints.
Her condition is known as anthrogryposis multiplex congenital (AMC) and occurs in about 1 in 3,000 live births, according to the National Institute of Health.
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She has had the condition since she was born but has never let it come in the way of her creativity.
Tillman, who is in her thirties and lives in northern California is now one of Sonoma County's premiere mouth and foot artists.
Her work spans from impressionism to pop art to street culture. Food and nature are among her influences and she says 'enjoys manipulating subjects in new and interesting ways', according to Fox 5 Atlanta.
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But Tillman has been painting since she was aged five - instead using her mouth and feet.
Her website explains how her surroundings have also inspired her work.
She said: 'Living in northern California has inspired me as an artist. With our dynamic landscape, ocean, vineyards, lakes and mountains: it is truly something to behold.
'I've used the environment and colors from nature as the inspiration for my artwork.'
And added: 'When working with my clients; my goal is to create artwork that evokes a feeling or memory while enhancing ones space.
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Some people may say painting with my mouth is a remarkable talent, however I want to be known for the quality of my artwork rather than how I created it.'
She explained how creativity was always encouraged in her household and added: 'I have been painting since I was 5 years old and haven't stopped since.'
Her past commissions include creating murals for children’s rooms, custom canvas works, greeting card designs, wedding invitation designs, decorative design and portraits.
Tillman is also a twin but they were not affected physical by the birth defect.
She is a member of Mouth and Foot Painting Artists of America (MFPA), which helps support those affected by accident or birth defects.
The organisation aims to take care of its artists’ interests by helping them to sell their work, primarily in the form of reproductions as greetings cards, calendars and other paper products, according to the site.
It also gives financial, practical and creative help to disabled people who are interested in becoming students to support them in becoming fully developed artists and members of the Association.
Alana Ciena Tillman was born with anthrogryposis multiplex congenital
A condition that has left her unable to contract or move some of her joints
But Tillman has been painting since she was five - and uses her mouth and feet
Her work spans from impressionism to pop art to street culture
She says her habitat of north California also inspires her work
By ALEXANDRA GENOVA FOR DAILYMAIL.COM
PUBLISHED: 17:49 EST, 28 March 2016 | UPDATED: 19:32 EST, 28 March 2016