'Before' image captured by MRI of man whose face had accidentally been shattered: ©AP via DailyMail.co.uk
Five years after a man accidentally blew off most of his face with a gun, 30 doctors at the Vall d'Hebron University Hospital in Barcelona, Spain provided him with a new face. The 24-hour surgery that involved removing the entire face of a deceased donor and transferring it to the recipient, was the first entire face transplant ever attempted and it has been, so far, successful.
The face transplant actually took place on March 20, 2010, but the hospital did not release the details until now. The recipient of the new face, who has not been identified, is said to be a man in his 30's who is a farmer. The horrific accident that physically disfigured him, left him unable breathe, swallow, and talk properly as well. He had undergone nine previous surgeries, but they were unsuccessful.
The following computer-generated image shows the area of the face that was transplanted - according to the hospital, "the entire facial skin and muscles, nose, lips, maxilla, palate, all teeth, cheekbones, and the mandible," - was achieved by plastic surgery and micro-neurovascular reconstructive surgery techniques.
Face transplant: Computer generated image, Vall d'Hebron University Hospital
Face transpant images showing the squence of the procedure: Computer generated images, Vall d'Hebron University Hospital, via DailyMail.co.uk
Dr. Joan Pere Barret lead the team of surgeons and other medical personnel involved in two separate operations. First, the donor face had to be removed and placed in preservation liquids - not just the lips, cheek and forehead, but all of the veins, arteries, muscles, skin and subcutaneous fat attached to them. In the middle of this 4-hour process, the recipient was prepared for surgery, after making sure that things were going well with the donor's procedure.
Then began the really long surgery on the recipient, involving both the retrieval team and the transplant team. Once the repair work was completed on the donors blood vessels, they were attached by microsurgery to the patient's own. Then the donors bones, muscles, and connecting nerves were transplanted, before the donor's facial skin was sewn on.
The first face transplant patient will remain in the hospital for two more months to insure that his body will not reject the transplant. That is the main reason that prior partial face transplants have not been successful in the past. But this patient has seen his new face and, though he is unable to talk yet, he is reportedly pleased with it.
Doctors say that the recipient will not look exactly like the donor, but will look somewhat like the donor and somewhat like himself.
Doctor Peter Butler, a British surgeon who has been waiting for a donor in Britain to carry out his first facial transplant, congratulated the Spanish team, saying that the lives of millions of people will be benefitted by this technology. In acknowledging the importance of this work, Dr. Butler showed enormous empathy for facially disfigured persons.
"Their quality of life is indescribably poor and many seldom leave their homes. They live an almost twilight existence, hiding in shadows and afraid to expose themselves to unforgiving public scrutiny.... If facial transplantation is successful, it will be the first option offered to those who live in that awful twilight zone, and not the last. It will give them the opportunity to once again walk along a street in broad daylight with nobody noticing."
Daily Mail, BBC News