Facial Transplants on the Horizon
In France 2005, Isabelle Dinoire’s face was revived after receiving a partial face transplant involving the mouth and nose because of a dog attack. Professor Jean-Michel Dubernard, Bernard Devauchelle and a group of surgeons used a brain dead person’s nose and mouth to rebuild Isabelle’s face. By 2006, Isabelle had made significant progress by regaining facial sensitivity, movement and had reaped aesthetic improvements to her face. For the past several years in Europe, facial transplants have been used to treat victims of trauma resulting in disfigurement.
In 2004, The Cleveland Clinic had been screening patients to apply microsurgical techniques in free tissue transfers to those afflicted as part of a study to refine the procedure. The definition of success in a facial transplant case is at the crux of controversy in the case of facial transplants. It is clear that improvement in quality of life for any traumatized victim is beneficial. Yet, medical research and development will continue until all protocols involving facial transplants are refined and prove beneficial in years to come.
The procedure involves the surgical removal of donor live tissue and recipient traumatized tissue so that the donor tissue can be surgically placed in the treatment area. In some cases, the procedure involves the replacement of fat, blood vessels, and nerves to help replace lost functionality resulting from the trauma. This is a very delicate procedure involving the transfer of very small increments of tissue at a time. While the success of free tissue transfer on the face is the primary focus of research and development, patients requiring a facial transplant may need facial implants (such as a cheek or chin implant) to complete the treatment plan.
The concern about facial transplants is in the difficulty of the successful transfer of nerves and blood vessels which control sensation and movement in the face. In addition, there have been reports of low immune system response in the treatment area because of the foreign donor tissue that is attached. Finally, the technique and complications management have not been standardized. Though, it is clear that the long term beneficial implications associated with facial transplants can be life changing events for people in years to come.
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