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Face transplantA face transplant is a skin graftthat involves replacing part or all of a patient's facewith a donor face.
PurposePeople with faces disfiguredby burns, trauma, diseaseor birth defectsmight benefit from the procedure. The alternative to a face transplant is to move the patient's own skin from their back, buttocks or thighs to their face in a series of as many as 50 operations to regain even limited function and a face that is often likened to a mask or a living quilt. Dr. L. Scott Levin, chief of plastic and reconstructive surgery at the Duke University Medical Center, has described the procedure as "the single most important area of reconstructive research." HistorySelf as donor (face replant)The world's first full-face replant operation was on nine year-old Sandeep Kaur, whose face was ripped off when her hair was caught in a thresher. The grass-cutting machine completely amputatedher faceand scalp. The machine caught one of Sandeep's braidsand then pulled her head in. Sandeep's mother witnessed the accident. Sandeep arrived at the hospital unconscious with her face was in two pieces in a plastic bag. Sandeep's doctor was Abraham Thomas, one of India's top microsurgeons. In 2004Sandeep was training to be a nurse. Photos An article in The Guardian recounts: "In 1994, a nine-year-old child in northern Indialost her face and scalp in a threshing machineaccident. Her parents raced to the hospital with her face in a plastic bag and a surgeon managed to reconnect the arteries and replant the skin." [1]The operation was successful, although the child was left with some muscle damage as well as scarring around the perimeter where the facial skin was sutured back on. In 1997, a similar operation was performed in the Australianstate of Victoria, when a woman's face and scalp, torn off in a similar accident, was packed in ice and successfully reattached.[2] Mouth and nose from another
The world's first partial face transplant on a living human was carried out on November 27, 2005[3]by a team of surgeons led by Professor Jean-Michel Dubernard(the surgeonwho performed the first successful hand transplantin 1998) and Professor Bernard Devauchellein Amiens, France. Isabelle Dinoire[4]underwent surgery to replace her original face that had been ravaged by her dog. A triangle of face tissue from a brain-dead human's nose and mouth was grafted onto the patient [5][6]. "Scientists elsewhere have performed scalpand eartransplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant." [7] Full face from anotherScientists at the Utrecht Universityand the University of Louisvilleare seeking approval for this experimental face transplant operation to be performed in the Netherlands. In 2004the Cleveland Clinicbecame the first institution to approve this surgery. Dr. Maria Siemionow's group, located at the Cleveland Clinic, is searching for its first patient. Surgery and post-operation treatmentThe procedure consists of a series of operations requiring rotating teams of specialists. With issues of tissue type, age, sex, and skin color taken into consideration, the patient's face is removed and replaced (including the underlying fat, nerves and blood vessels, but no musculature). The surgery may last anywhere from 8 to 15 hours, followed by a 10?14 day hospital stay. After the procedure a lifelong regimen of immunosuppressivedrugs is necessary to suppress the patient's own immune systemsand prevent rejection. Long-term immunosuppression increases the risk of developing life-threatening infections, kidney damage, and cancer. The surgery may result in complications such as infections that would turn the new face black and require a second transplant or reconstruction with skin grafts. Psychological effects of the procedure may include remorse, disappointment, or grief or guilt toward the donor. The transplant does not give the patient's face the appearance of the deceased donor's face because the underlying musculature and bones are different. Facial movements are due to the brain so the personality as expressed by the face remains that of the patient. Only the skin of the face is transferred from the donor, not the three dimensional shape nor the personality it expresses. Popular culture1960: The procedure was very grotesquely, yet somewhat accurately, highlighted in Georges Franju's 1960cult horrormasterpiece called Les Yeux sans visage which translates to "Eyes Without a Face". 1964: Kobo Abe, Japanese authorand playwright, wrote The Face of Another (novel)(1964) about a plastics scientist who loses his face in an accident and proceeds to construct a new face for himself. With a new face, the protagonistsees the world in a new way and even goes so far as to have an clandestine "affair" with his estranged wife. His novel was made into a movie by Hiroshi Teshigaharain 1964 (Teshigahara made a film of Abe's novel Woman of the Dunes) 1990: In the 1990movie Darkman, the central character Peyton Westlake grafts himself a synthetic face after his skin was burned in a lab accident. He uses this new material to disguise himself and hunt down the criminals responsible for his mutilation. 1997: The plot of the 1997movie Face/Off was based on a face transplant operation that involved changing the underlying structure and actual face shape. 2003: The villain in the movie Once Upon A Time In Mexico underwent a face transplant. 2005: Facial transplant surgery was featured in a 2005episode of Nip/Tuck. The patient's body rejected the face, and it had to be removed. References
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fi:Kasvojen siirto fr:Greffe de visage de:Gesichtstransplantation Categories: Surgery| Transplantation medicine
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