Three Full-Face Transplants

February 22, 2012

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The New England Journal of Medicine has recently published a report about the first three people who had received full-face transplants at Brigham and Women’s Hospital in Boston, US in 2011.

Bohdan Pomahac, director of the plastic surgery transplantation program and the lead author describes the three cases as extensive procedures that required grafting not only the skin, but also nerves, muscles, blood vessels, and structures such as the nose.

All three patients had previously experienced extensive injuries to the face: the first patient was injured in 2008 when he came into contact with a power line. The second patient also experienced a severe electrical burn, while the third patient was a victim of a chimpanzee attack in 2009.

According to Pomahac, the main obstacle to the surgery had been the belief that you’d need to connect four arteries and a corresponding number of veins in order to provide enough blood flow to the transplanted tissues. But the team at the hospital used a simplified method, connecting just one artery and one vein on each side of the face.

The surgeons also connected all the main available motor and sensory nerves, in an attempt to restore function to the face. Pomahac said that in time, patients can expect to recover up to 75% and 90% of facial function.

The patients’ new faces resemble neither their own pre-accident faces, nor those of the donors. But through post-surgery counselling, they quickly got used to their new look. The patients will be followed over time to make sure they regain their motor and sensory function.

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