December 19th, 2008
10:30 AM ET

Facing a normal life

By Shahreen Abedin
CNN Medical Senior Producer

It’s hard to imagine not being able to go to the grocery store, or even step outside to the mailbox, out of fear of humiliation or name-calling by random strangers. And yet the woman who underwent the first successful face transplant in the U.S. two weeks ago endured these challenges on a daily basis, according to her doctors. She was robbed of a normal life when she suffered a severe trauma to her face; she lost 80 percent of it: the middle of her face was gone, as was her right eye, nose, and upper jaw bone. She could not smell, taste, and had trouble speaking and communicating. The medical team said it took 20 years of preparation, 22 hours of surgery, and months of tireless preparation using microsurgical techniques for the medical team to hook up blood vessels, nerves, and all the tiny tissues, with hopes of restoring one woman’s dignity and quality of life. Her sibling wrote a letter to doctors at the Cleveland Clinic, saying how overwhelmed they were to think of the patient finally on the road to returning to a normal life.
Isabelle Dinoire underwent the first partial face transplant in France in November 2005

Isabelle Dinoire underwent the first partial face transplant in France in November 2005

But how normal can it be? Imagine looking in the mirror and seeing someone totally different – the face of the transplant tissue donor? No - that’s not really what happens, as we've seen in the case of Isabelle Dinoire, the French woman who underwent the very first partial face transplant in Lyon, France, three years ago. Although today she doesn’t look like she did before her face was mauled by her dog, she also doesn’t look like the transplant donor; she has a different visage altogether. She faces a lifetime of taking anti-rejection drugs, and was reported to have twice experienced violent reactions to the new tissue, and the drugs caused infection and even kidney failure.

The Cleveland Clinic docs strongly emphasized that this isn’t just a cosmetic procedure (although it does involve plastic surgery), and they were very careful about picking the right person. After exhausting all other possible treatments, and after rigorous physical and psychological evaluations, she was chosen to receive the transplant. But it’s just a matter of time before they do the first full face transplant, and surely down the line, the procedure will become more and more frequent.

Do you foresee regular, healthy people (with lots of money!) undergoing face transplants just for the heck of it? If so, do you have a problem with it, moral, ethical, or otherwise?

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