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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soundoff (6 Responses)
  1. GF, Los Angeles

    I don't forsee regular healthy people getting a face transplant just for the heck of it. Living with the knowledge that the body could reject the transplant and having to take a lifetime of drugs is not a road most people would take – maybe a couple.

    December 19, 2008 at 17:30 | Report abuse | Reply
  2. Judy Ryan

    It is difficult for most to view this kind of surgery "from the outside looking in" unless you've lived with facial conditions that cannot be corrected without causing further deformity or injury. Without living day-to-day with severe cosmetic and functional issues, no one can truly understand or judge the patient.

    As a 31-year survivor of embryonal rhabdomyosarcoma - a large malignant tumor that occupied the entire left side of face at the age of 16, I was highly engaged and excited when I first heard of facial transplants. Having undergone 20+ reconstructive facial surgeries in my lifetime I know the drill: the risks of infection, surgeries that make matters worse...and conditions for which there are no solves.

    Due to radiation treatment, I lost vision in my left eye, hearing in my left ear, trimus with eventual removal of part of my jaw in order to open my mouth wider that a 1/4", permanent baldness to my left scalp, severe skin and tissue damage which had to be replaced...and as a result of multiple surgeries, facial paralysis.

    With all that said, I live a very sweet life. I missed only one year of employment my entire adult life, I happen to be extremely fit, healthy, happy, great career, financially stable, date regularly...yada, yada, yada.

    And I say all that because I can view this surgery from a point-of-view as someone who 'gets it' and is emotionally stable. I am offended by those who look upon this as unethical or as surgery 'gone too far.'

    Interesting isn't it how acceptable it is for so many to clone their appearance: fluff their face with botox, blow up their lips with collagen and so much more when there really is nothing wrong with their appearance. It's instead, their self image that's broken. They want their features to resemble someone else. A sad state of affairs that has been going on for years and is now out of control.

    Let me just say that when injury or disease affects the health or function of someone's face, that individual deserves every reasonable means available to correct/restore their face to health.

    This is about health, and dignity first. Those of the general public who question this procedure don't know how strong & well grounded many of these individuals are. Unfortunately that is the result of the lack of press exposure on topics of individuals of facial difference. There is an occasional story...a token tale offered every..say 6 months, which from a media perspective, covers the subject. Well it does not.

    If there is any lack of understanding of how marvelous this surgery is, it's because no one has anything to compare it to. Facial difference is a foreign and obscure topic that no one wants to discuss.

    It's time to talk.

    Embrace the great advancement this surgery offers. Let's not treat this like a freak show or underestimate the bravery of the individuals who choose to undergo this procedure.

    Whoever requires this type of repair is a hero! And the doctor who performs the ground-breaking surgery, a saint...to step outside the box in order to respectfully improve that patient's quality of life.


    December 20, 2008 at 23:50 | Report abuse | Reply
  3. Nancy

    Thank you for your comments. We, at the American Society of Plastic Surgeons, would love to talk with you more regarding your experience, your thoughts on facial difference and the public's lack of understanding. You can reach us at media@plasticsurgery.org.

    I agree, its time to talk and embrace the great advancements in reconstructive plastic surgery.

    The public can learn more at http://www.plasticsurgery.org.


    December 22, 2008 at 10:49 | Report abuse | Reply
  4. Kathy

    FANTASTIC attitude Judy. And Thank you Nancy for inviting her to speak with your society in order to further understanding and learning. What a wonderful 'set' of New Year's notes.

    December 31, 2008 at 21:05 | Report abuse | Reply
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