Thursday, December 18, 2008

Face Transplantation – First in the US Done


Yesterday, Cleveland Clinic shared information on the first face transplantation done here in the United States. It involved replacing over 80% of the woman’s face. You can read more here and see the interview here. If you go here, you can see a visual “explanation” of the surgery.

I wrote a post on face transplant in March when Pascal Coler had his FULL face transplant done. He had spent much of his life horribly disfigured by Von Recklinghausen's disease. It is a rare genetic disorder suffered over 100 years ago by Elephant Man Joseph Merrick (played by John Hurt in the movie).

As I said then, I am watching this procedure with much fascination at the possibility for improving someone life. Pascal’s case is a great example. Yes, there is the great risk with this procedure, but in this man's case and in his words

"My chance had finally come. Even with the risk of dying, there was no question of me hesitating."

Isabelle Dinoire would agree with Pascal Coler. She is now three years out from her surgery and has gained some function (ie smile, blinking) of her facial muscles. Here are photos and a quote from Isabelle Dinoire (the first person to receive a face transplant) are from a CNN article yesterday

In 2005, French doctors performed the world's first partial face transplant on a 38-year-old woman who was disfigured when she was attacked by a dog.

"I hope the successful operation will help other people like me to live again," said Isabelle Dinoire, the French woman who received a nose, lips and chin.

This comments made in this article [Surgery Transplanted Most of Patient's Face; CNN article, Dec 17, 2008; by Madison Park] show the divide between those for and against this procedure:

Candidates for a face transplant are survivors of trauma, such as burn or accident victims, who have exhausted all other reconstructive possibilities. The recipient in France, Isabelle Dinoire, had been mauled by a dog, and the Chinese man, Li Guoxing, was attacked by a bear. Both suffered major facial disfigurements.

Facial transplants are not a question of vanity, Siemionow said in the 2006 interview. Some patients have undergone 30 to 40 reconstructive procedures hoping to have some normalcy in their appearances.

"Those people are not coming in with such a commitment because they want to be beautiful," she said then. "They want to be normal."

But critics, such as Peter A. Clark, director of the Institute of Catholic Bioethics at St. Joseph's University, in Philadelphia, Pennsylvania, said a facial transplant introduces unnecessary risks for a procedure that is not a matter of life and death.

"With something like a liver or kidney transplant, it's a life or death transplant," Clark said. "Even with a kidney or liver [transplant], you have to be put on immunosuppressants with serious side effects."

Clark suggested the viable option is reconstructive surgery, which would not require immununosuppressants. But doctors say that reconstructive surgery has its limits.

"If you look at the outcomes, they're far superior doing a face transplant than any reconstructive surgery," said Dr. David Young, a professor of plastic surgery at the University of California, San Francisco.

Young said plastic surgeons who do large facial reconstructions often find that patients "never really look that great." "Anyone telling you that doing reconstructive surgery is as good is deluding themselves," he said.

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2 comments:

Dr. Val said...

Of course, I'm dying to see the results. :)

GingerJar said...

I worked with an RN in Beaumont, TX who had been horribly burned as an infant or toddler, I don't recall which. She was in a crib in an apartment fire. Her face and ear's literally look like they were melted off. She had horrific scars. Sometimes patient's would ask for another nurse because "She scared me". I always felt so sorry for her. She never married. She had no children. She was bitter at times, and kind at others. Too bad something like this couldn't be done more often.