Facial transplant surgery

Now available as an option for patients with severe facial injuries

French plastic surgeons have carried out the first successful face transplant (she has normal sensation) on a woman who had lost her nose, lips, and chin after being attacked by a dog is both exciting and disturbing. Exciting because it raises hopes for victims of burns and accidents and gives them another chance to live a more "normal" life. Disturbing because it raises some ethical issues.

The number of cases of plastic surgery for purely cosmetic benefits is so high that we often forget that for many people, it is their only hope for a more normal appearance or lifestyle. For instance, victims of burn or accidents often need extensive surgery to regain their normal look and/or bodily functions.

In a facial transplant procedure, tissues, muscles and blood vessels are taken from a dead donor and attached to the patient's lower face. In fact, this is the major ethical concern that many people have. Not everyone is comfortable with the idea of using parts from a dead person, particularly when it means that the face of the dead person will be disfigured in the process.

Such cosmetic surgery procedures are, however, not easy and many challenges still lie ahead. In the journal Expert Opinion on Biological Therapy, Dr Peter Butler of the Royal Free Hospital shares his thoughts on the potential of facial transplantation as a reconstructive surgery option after severe facial injury and disease. "The ability to reconstruct complex facial injuries is still a considerable challenge despite the development of microsurgical techniques, with surgical results in this group often poor in terms of function and appearance. Facial transplantation may provide a potential solution; however, opinion is currently divided about the extent to which the potential quality of life benefits weigh against the technical, psychological, and immunological risks," he says.

John Barker, director of plastic surgery research at University of Louisville, said if the pioneering procedure is successful, it could offer a “new and potentially better option” for facially disfigured people for whom other treatments are not viable. “This is an exciting development, and we will be following the outcome closely for the medical, psychological and ethical information that may be gained,” Barker said. (Related: ContourLift)

Of course, as time passes, there are many technical and ethical issues to be dealt with related to face transplants but Dr. Peter Butler thinks that as an alternative to the current options for facial reconstruction, and as a means of offering a vastly improved quality of life for a few severely disadvantaged people, it is hard to argue that face transplantation will not soon justify its place on the reconstructive ladder.