In 1996, a facial transplant surgery was featured in an episode of Star Trek: Voyager and in 2005 was featured in an episode of the plastic surgery drama Nip/Tuck . But how real is the possibility of facial transplant in society today?

Over the last 10 years or so, surgeons in many countries—including the Netherlands, England, Japan, France, Spain, Italy and even the United States—have been planning and preparing to perform facial transplants.

The First Facial Transplant

In May 2005, Isabelle Dinoire had the first partial face transplant in France. Dinoire was severely disfigured after being mauled by her dog. In November 2005, surgeons grafted the lips, nose and chin of a brain-dead woman onto Dinoire's face.

“I have returned to the planet of human beings-those with a face, smile, facial expressions that let them communicate. I am alive again,” Dinoire said in a statement.

Ideal Candidates for a Facial Transplant

Candidates for facial transplants include those who are severely disfigured by burns, traumatic injuries or birth defects.

Dr. Peter Constantino, a physician at St. Luke's-Roosevelt Hospital Center in New York, is a part of a team considering facial transplant for a child whose face is disfigured by a tumor.

Constantino believes that face transplants, at the given time, should be for people that experience an extreme loss of function like a mouth or eyes that aren't functional.

In the past, when an individual became facially disfigured, plastic surgeons would graft skin from the patient's back, buttocks and thighs onto his/her face. This constituted a series of over 50 different operations and still only gave patients limited feeling and mobility in their face.

For patients who had the procedure, it was like living with a mask on their face all the time. Also, patients were left with patchy, unfavorable appearances.

Facial Transplant Procedure

According to doctors at the Cleveland Clinic, a full facial transplant has 4 steps as follows:

• A surgical team peels away the face of the recipient patient to prepare for a new one from a donor.
• Surgeons attach the donor face to the patient by attaching the top of the face to the frontal bone of the skull. Ligaments and connective tissue around the eyes, jaw and ears are the first areas attached.
• Doctors reconnect key blood vessels, which will pump blood back into the donor tissues from the recipient's own blood supply.
• The final skin incisions are stitched and anti-rejecting drugs will be administered to keep the body from rejecting the tissue. A full recovery with feeling in the face could take months.

Prior to the procedure, doctors will have matched the recipient and donor for tissue type, age, sex, and skin color. The resulting appearance is often a mix of the recipient and donor since the recipient's muscular and facial structures are usually retained.

Medical Centers Prepare for Facial Transplant Procedures

The doctors, psychiatrists and ethicists of the Cleveland Clinic have been gearing up since November of 2004 to perform the first full facial transplant. This was the year that the Institutional Review Board gave approval to the medical facility to perform the procedure.

In July of 2007, Brigham and Woman's Hospital in Boston became the second hospital in the United States to make public the hospital's plans to offer this rare operation.

Doctors Weigh In

Surgeons and medical experts are excited about the procedure and its potential to help certain patients.

“For the first time, we have scientific data that takes us beyond traditional reconstructive techniques and partial facial transplantation,” said President of the American Society of Plastic Surgeons, Dr. Bruce Cunningham.

Dr. Rod Rohrich, editor of the journal of Plastic and Reconstructive Surgery , also weighed in: “This is an exciting time in plastic surgery, but it is important to remember that, at least in the near future, facial transplantation will be a last resort procedure performed on carefully selected patients on a case-by-case basis.”

In 2005, about 12 men and women secretly visited the Cleveland Clinic to be reviewed for the procedure by Dr. Maria Siemionow and her team of experts. According to the Dr. Siemionow, these individuals have lost the sense of identity that is linked to the face and facial transplant surgery can help restore a traumatized patient's sense of identity.

(Article by: Donna Corrado)

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