Monday, August 29, 2005
First Face transplantation
Peter Butler of the Royal Free Hospital in London said that face transplantation will be the only effective way of treating some severely disfigured patients, such as those who have suffered extensive burns or facial cancer.
But his own survey of 120 people including nurses and doctors revealed that while some would be willing to receive a face transplant, none would be prepared to donate their own face. Butler hopes that if full details of the procedure and its medical need are made clear, potential donors might be able to overcome their initial revulsion.
The recipient would not look like the donor, Butler stresses. Martin Evison, an expert in forensic facial reconstruction at the University of Sheffield, UK, agrees. "The musculature of a face is particular to a skull as it develops. Muscles in the face of one person would have to be re-sculpted if they were to be transplanted onto another skull - and the face would not look the same," he says.
A face transplant would involve removing the face, facial muscles and subcutaneous fat from the recipient. The donor face from a recently dead person, complete with lips, chin, ears, nose, eight major blood vessels and even some bone, would then be grafted into place.
The loss of facial tissue is a devastating injury, Butler says. Skin from other parts of the patient's body can be transplanted, but he or she cannot move this skin, creating a mask-like effect.
Encouraging the regeneration of cut facial nerves in the recipient - essential for movement and sensation - will be key to a transplant's success. This will not be easy or immediate, but recently developed growth factors and even immunosuppressants will speed the process, says Butler.
In the past, skin's particularly potent ability to stimulate the immune system if grafted from one person to another had been a barrier to attempting face transplantation. But new immunosuppressants have permitted successful hand transplants, for example.
And Butler thinks advances in microsurgery over the past few years now make the procedure technically possible. He says he plans to conduct anatomical experiments over the next six months to demonstrate the feasibility of a transplant.
The idea of taking off a dead person's face and putting it on someone else appears to have come straight out of science fiction, Butler wrote in a commentary in the Lancet in July. But if face transplantation is shown to be the only effective way of treating severely disfigured patients, then doctors would have a duty to use the technique, he concluded.
Only one parts is balance in our body to transplant, it’s the Brain.
Face transplants will be technically possible, now the public must decide whether the procedure is ethically acceptable, says a leading UK plastic surgeon.