Anatomy of a Face Transplant

In the operating room

The operation itself will involve a three-step procedure, in which the first team will remove any skin grafts and any other reconstructive surgery from the face of the patient. The second team will remove the skin, underlying fat and eight different blood vessels, four arteries and four veins from the face of the donor. As with organ transplants, the face will then be transported on ice to the patient, where a delicate, microsurgical operation lasting an expected fourteen hours will take place.

 

Credit: CHU-Amiens

3D model of the reconstruction of the nose, lips and chin in the first partial face transplant. Arteries are red, veins are blue, nerves are yellow and muscles are dark red.

Even though the knowledge and skills now exist to perform face transplants, there are various ethical concerns that still need to be considered. The procedure requires a living donor – typically a person who is on life support and deemed brain dead. This raises the issue of ethics with regards to consent of the donor, and could limit the number of face transplants that can be carried out.

In terms of the recipient, the transplant does have its risks. When the new face is attached during surgery, there is the possibility of clotting in the blood vessels of the new tissue. Afterwards, there is always a chance that the person’s body will reject their new face. The human immune system naturally resists foreign tissue and so someone who has received a face transplant would need to take anti-rejection drugs for the rest of their life. In addition, taking these drugs can increase the person’s chances of developing cancer in the future.