Surgery and Medicine - Face Transplant

Your face is one of the main things that identifies you. It helps you to express yourself in a myriad different ways and influences to a large extent the way you relate to the world. With a different face, your experiences would no doubt be different. Our face is something we take for granted mostly, but what would you do if you lost your face? Unthinkable as the notion is, this kind of tragedy has indeed befallen on quite a few people, either from disease or accident. So far, in these cases, skin grafts taken from other parts of the patient's body are used and it takes several operations to reconstruct the entire face in this manner. The end result, since the important nerves that control expressions are missing, is often mask-like. Not unnaturally, this can bring on several psychological problems with the patient finding it difficult to adjust in a regular social environment. The innovations in medical science now offer some measure of hope for these people so they can lead a relatively normal life. Face Transplant, which involves grafting the face skin, including the nerves and muscles, of a donor onto a patient's face and which would allow a greater degree of facial movement, is now a reality.

How is Face Transplant done?
Face Transplant is done using Microsurgical Procedure. The face skin of a brain dead, live donor, along with blood vessels, veins, and arteries, is grafted onto the face of the patient, whose own damaged face skin and underlying nerves and fat have been removed in preparation for the graft. There are a lot of risks involved in the procedure and the chances are high that the body may reject the new skin or that infection may set in. The patient has to take expensive immunosuppressive drugs for the rest of his or her life and may also need to undergo extensive psychological counseling to cope with living with a new face and the life changes it requires.

A Consultant Plastic Surgeon at London's Royal Free Hospital, Dr. Peter Butler, has received permission from the NHS Ethics Board to carry out Full Face Transplant Surgery.

Recent Face Transplant Surgeries
One of the successful face transplants carried out in recent times was on 27 November 2005 on a 38 year old Frenchwoman named Isabelle Dinoire, whose face had been extensively damaged in an attack by her pet dog. After numerous counseling sessions, Ms. Dinoire underwent partial face transplant surgery in Amiens under Professor Jean Michel Dubernard and Professor Bernard Devauchelle. Her nose, mouth, and chin were successfully reconstructed and, while she will have to take immunosuppressive drugs her entire life, she is so far doing fine according to her doctors.

Misconceptions and doubts about Face Transplant
Although popular movies like Face Off, for example, denote otherwise, getting a face transplant will not make a patient look exactly like the donor. This is because, in face transplant, only the skin of the donor is grafted onto the patient. The underlying bones and muscles and the expressions which make a face unique remain those of the patient. So there is no question of a resemblance to the donor. However, the patient will not look like he or she did before the disfigurement either. It will be an entirely new face.

Even so, when asked, many people, and this includes those in the medical profession, show a distinct disinclination about donating their faces after their deaths. It is afterall an entirely different matter from donating other body organs like kidneys or eyes.

Medical ethicists also question if the risks involved are worth the procedure. In case the surgery fails, then where does that leave the patient?

Many people, who have suffered serious disfiguration, have also expressed deep doubts and reservations about undergoing a face transplant. Aside from the surgery, its after-effects, and the possibilities of failure, the idea of 'wearing someone else's face' is deeply disturbing.

However, for others, it could mean a lessening of the daily trauma, a possibility of returning to a modicum of normalcy, of having gained a new lease on life.