The Looming Controversy Surrounding Facial Transplant

Jacqueline Saburido was a very normal girl who was in pursuit of her dreams until 6 years ago. A tragic incident that occurred on the 19th of September 1999 changed her life. She met with a road traffic accident in which more than 60% of her body was burnt. She lost her ears, nose, left eyelid and most of her vision. She also lost her hair and had an amputation of her fingers. She has had more than 50 surgeries since then and has a lot more to go. A corneal transplant done in 2003 enabled her to see through her left eye in 2003. She is now one among the 20 patients to have approached Dr. Peter Butler for a face transplant believed to take place next year.

While the proposed recipients are awaiting clearance from the ethical committee, the first partial face transplant has been conducted on Isabelle Dinoire whose face (lips, nose and chin) was torn off by a dog. The specialized microsurgery enabled her receive facial tissue from a brain dead donor after completion of all required legal and medical formalities.

Although several issues have been raised against detractors regarding the feasibility of a face transplant, members of the medical community argue that this is a much more convincing approach that the traditional graft method that would require multiple surgical interventions. In addition, it is technically much easier to perform a facial transplant than to work and rework on an already disfigured face.

The partial face transplant involved removal of the facial skin (along with fat), blood vessels and connective tissue from the dead donor, followed by transplantation of the graft into the recipient's face. The foreign tissue was then stitched together with the donor's to ensure blood supply to the implanted graft.

Many of you reading this section would probably wonder if the new transplanted face would resemble the donor's. It is indeed true that such a transplant can be performed only after ensuring that there is an acceptable level of match between the donor and recipient in terms of the blood group, tissue, skin color etc. But this does not mean that the donor and recipient would look alike. The unique arrangement of the bones of the face (recipient) would ensure dissimilarity of the 'new face'.

The currently existing alternative for patients whose face has been disfigured beyond recognition is the skin graft method that is based on rebuilding the damaged part through muscular and skin flaps taken from elsewhere in the body (most commonly from the thigh and back). The only advantage of this procedure is that the problem of immune rejection is circumvented due to tissue compatibility.

Even while members of the medical community and the general public are arguing over the acceptance of face transplant, the option would seem much more compelling for somebody who would otherwise have to undergo at least 100 operations for restoration of their near normal facial appearance. It would impart a whole new confidence to individuals such as Isabelle Dinoire and Jacqueline Saburido and to chase their dreams.