In late March, 2011, Dallas Wiens became the first American patient to receive a full face transplant. Worldwide, 15 reported face transplants have been performed on individuals with severe facial disfiguration from burns and other injuries. As medical and technological capabilities advance, and as more face transplants are successfully performed, doctors near a medical standard of care for this groundbreaking treatment of severe injuries.
According to Dr. Michael Yaremchuk, Chief of Craniofacial Surgery at Massachusetts General Hospital and a clinical professor of surgery at Harvard Medical School, a person must have severe facial disfigurement that cannot be repaired by conventional plastic surgery in order to receive a face transplant. Although it is not yet a standard treatment, face transplantation may be appropriate when an individual's tissue loss is so extensive that multiple surgeries and reconstructive procedures provide little improvement.
That was the case for Dallas Wiens, who, before receiving a face transplant, had skin grafts from his back and thighs completely covering his face. Wiens was severely burned by an electrical power line when working on a cherry picker to paint a church in Texas. The high voltage he encountered in the work accident burned off most of his facial features and blinded him, leaving him with just a hole for his mouth after many surgeries and months of recovery.
Weighing the Benefits and Risks of Face Transplants
With traditional organ transplantation, the benefits of the transplant significantly outweigh the risks of undergoing the procedure. A patient may die if he or she does not receive a new heart, kidney or liver. For possible face transplant recipients, however, the main benefit is improvement in their quality of life; therefore, the procedure is more difficult to justify, said Dr. Yaremchuk.
Similar to many other transplant recipients, individuals with face transplants must take immunosuppressive medicine for the rest of their lives. If they do not, they risk their bodies rejecting the transplant. But, living with intentionally-suppressed immune systems can also make transplant recipients susceptible to illness and other health concerns.
Face transplantation remains an exceedingly rare procedure that is neither recommended nor available for all individuals with severe facial injuries. However, as transplant therapy evolves, face transplantation may eventually become standard treatment for individuals with severe facial disfigurement.
