Texas man gets first full face transplant in U.S.
March 21st, 2011
04:04 PM ET

Texas man gets first full face transplant in U.S.

Dallas Wiens may soon be able to kiss his daughter, Scarlette, again, now that he has become only the second person in the world to receive a full face transplant.

The 25-year-old Wiens, who lives in the Dallas-Fort Worth area, received the new face at Boston's Brigham and Women's Hospital last week, when a family donated a loved one's tissue for the transplant surgery.  The forehead, nasal structure, nose, lips, facial skin and underlying muscles and nerves that allow Wiens to move his face and have sensations were transplanted.  The hospital would not reveal the actual surgery date to protect the privacy of the donor family.

"Dallas was injured in November 2008 when his face got too close to high-voltage line while on the job," Dr. Bohdan Pomahac, Brigham and Women's Burn Unit director, told reporters Monday. "He sustained devastating injury leaving him with bare bones instead of face."

Dallas Wiens before his surgery

Pomahac said the purpose of the full face transplant is to restore "human appearance and function." After his face healed from the accident, Wiens' only facial trait was his mouth. Once his new face heals, he will not look like himself, nor will he look like the donor because the new tissue will mold to the young man's remaining tissue and bones.

Wiens' grandfather, who is with his grandson in Boston right now, calls the surgery a miracle. He says after his grandson was so seriously injured, he did not know what would happen.  His grandson, he says, is  determined to "get well and move on with his life and make something of his life."  Wiens has been walking and talking to his family in Texas by phone.  Doctors expect he will be eating on his own soon.

His doctors expect Wiens will eventually regain sensation on his forehead and right side of the face and most of the upper and entire lower lip. Damage to a few nerves on his left side were too severe, so doctors do not expect very much sensation to be restored to his left cheek and left forehead.

One thing surgeons couldn't restore was his eyesight. "Unfortunately we do not know how to transplant, at the current age, eyes, so we were not able to restore his vision," said Pomahac.

Pomahac said when he first saw Wiens' injuries he feared they were too extensive to allow for a new face to grafted on. The blindness was also a consideration. But, Pomahac says,  "We have the obligation to help if we can."

Last April,  surgeons in Spain successfully completed the first ever full-face transplant. Three months later, the patient, only identified as "Oscar" stepped before the cameras of the world.

In December 2008, Connie Culp became the first American to receive a "near" full-face transplant after surgeons at the Cleveland Clinic replaced more than 80% of her face in a 22-hour operation. Culp had survived being shot in the face by her husband.

France's Isabelle Dinoire, who was mauled by a dog, was the first person ever to receive a face transplant back in November 2005. French surgeons replaced part of her face, including her chin, lips and nose, with those from an organ donor.

Brigham and Women performed its first partial face transplant in 2009. According to Pomahac, that patient is now on the lowest dose of anti-rejection drugs compared with the other face transplant recipients in the world.

Wiens' doctors say he is doing great and meeting all his milestones.  They say he will stay in the hospital for the near future and eventually return to Texas.  But recovery of the nerves will take months.

Pomahac says two other patients are waiting for face transplants at Brigham and Women's.  He believes  face transplants will continue to be rare unless the qualifications for the surgery change or more qualified patients are found.

Before a patient can receive a face transplant, a blood and tissue match has to be found, plus a patient has to be able to comply with taking the necessary drugs to prevent the rejection of the new face.  Also, patients need to be mentally capable of handling having a face that is different from their own.

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