Face Transplant

A treatment option for some people with severe facial disfigurement is called face transplant. In this procedure, it replaces part or all of a person’s face with donor tissue from someone who has died.

This procedure is only done in a few transplant centers worldwide and a complex operation that involves months of planning and will have multiple surgical teams.

The surgical team will evaluate the person who is a candidate for face transplant to make sure the best possible results in function and appearance.

This is a high-risk procedure but may enhance your way of life. The surgical team cannot predict the outcome when it comes to how you will look exactly and how your immune system will respond to your new face.

Your doctor will prescribe you with immunosuppressant drugs for reducing the risk of your body rejecting the transplanted face for the rest of your life.

Here are the most common reasons to undergo a face transplant procedure.

To improve the quality of life of a person badly disfigured by facial burns, trauma, birth defects or disease is the reason a face transplant is performed.

This will enhance the person’s functional abilities such as swallowing, chewing, breathing and talking through the nose and appearance.

In some cases, they want to undergo this procedure so that they will not be isolated anymore because of facial disfigurement.

A face transplant is a challenging procedure and very complex and new. The procedure is accompanied by various potential risks.

There are an approximately 30 people known to have undergone a face transplant ranging in age from 20 to 60, between the years 2005 to 2014 but at least three have died because of the infection on rejection.

The possible complications can result from:

• surgery
• your body will reject the transplant tissue
• side effects of immunosuppressant drugs

The surgical risk is a long-term procedure and is very complicated because this is life threatening. You will be in surgery for 10 or more hours and it will include blood clots, blood loss, and infection.

They rejection risk is when your immune system rejected the donor tissues and your new face. You could lose all or part of your new face and some function as well.

Your doctor may give you intensive IV dose of anti-rejection drugs to help in controlling the rejection response. This can lead to death if the rejection was not controlled.

The signs and symptoms of rejection include a change in the color of your skin and swelling. The immunosuppressant risk is when the anti-rejection drugs that you will need to take for the rest of your life will make your immune system weak.

This will put you at risk of different infections even if this will prevent tissue rejection. Diabetes, cancer, kidney damage and other serious conditions are all linked to immunosuppressant drugs.

To prepare for a face transplant, think of these questions:

• Do you know the risks of the transplant?
• Are you fully committed to the long-term follow-up care?
• What benefits will you gain from this surgery?
• Have you tried discussing with your doctor about other treatment options such as conventional facial reconstruction or facial prosthesis?

First, you will be evaluated, candidates should:

• have severe facial disfigurement
• have lost facial function such as talking or chewing
• undergo an evaluation of their emotional and mental health, family, and social support, coping skills, communication skills, expectations, ability to manage the post-transplant care
• undergo comprehensive exam such as MRI and CT scans, x-rays, blood test and measures of physical health
• not pregnant
• no history of chronic nerve conditions
• had no recent infections
• have no serious medical problems such as diabetes, cancer or heart disease
• no abuse illegal drugs or alcohol
• be nonsmokers
• complete a financial evaluation of post-transplant care expenses

When the transplant team approved the transplant you will be on a waiting list.

Surgeons will consider some factors when matching you with a donor face such as:

• blood type
• tissue type
• comparable ages of donor and recipient
• skin color
• the comparable facial size of donor and recipient

While waiting, you can:

• undergo pre-surgery evaluations such as visiting transplant centers so that the team will do blood tests and evaluate if you are now ready for transplant
• arrange for travel and lodging because you have to stay in an area or location that will allow you to arrive at the hospital in a short time for the transplant date and you will be asked to stay near the transplant center after two to three months of surgery
• staying in touch with your transplant team
• staying in touch with your transplant team if you are going to have changes in your medical care such as blood transfusion or starting new medications

Here’s what you can expect before, during, and after your face transplant procedure.

Your surgical team will include plastic surgeons that are skilled in craniofacial and microsurgery, ophthalmologists, anesthesiologists, surgical technicians, surgical nurses, imaging experts and others.

The length and extent of your surgery will be based on how much of the face and its underlying structures are involved.

Your surgical team may transplant various tissues from the donor such as fat, muscles, skin, cartilage, tendons, blood vessels and bone nerves. This face transplant will take up to 10 to 30 hours.

After surgery you will mostly spend two to four weeks in the hospital and during this time you will:

• be fed through a tube
• be given medications to manage pain
• begin taking your daily doses of immunosuppressant drugs for the prevention of your body rejecting the tissue
• begin speech and physical therapy

The team will work with you to develop a post-surgery treatment plan. Your team will monitor the immunosuppressant drugs that you are taking for the managing of side effects and can help your immune system not to reject the donor's face.

The risk of rejection is decreased by:

• regularly taking the immunosuppressant drugs as advised by the doctors for the rest of your life
• making regular visits with the team for blood tests and physical check-ups
• consulting the team if you notice any tissue rejection or infection

If you do not understand your face transplant results, consult with your doctor.

You will not know if this will work and each recipient had different experiences with the post-surgical function and appearance.

Most experienced improved ability to drink, eat, smell, smile, talk and make facial expressions.

Your results will be affected by:

• the extent of your operation
• your body’s response to the new tissue
• nonphysical aspects of your recovery such as psychological and emotional response

This procedure is just new so long-term results for people who had this are yet to be determined.

By seeking the support of your family and friends and the team, you will have an increase chance of a positive outcome.