Who is a good candidate for a face transplant?
What are the ethical concerns of a face transplant?
What is the risk of the recipient's immune system rejecting the new face?
What should the candidate expect over the first year after transplant?
Will the candidate look like the donor after face transplantation?
Q: What is face transplantation?
A: Face transplantation is part of an emerging field of transplant called Vascularized Composite Tissue Allotransplantation (VCA). This is the transplantation of skin, blood vessels, nerves, bone, muscle and other supportive structures from a donor to a candidate.
Face transplantation includes: the facial skin, the nasal structure, the nose, the lips, the muscles of facial movement used for expression, the nerves that provide sensation, and, potentially, the bones that support the face.
Q: Who is a good candidate for a face transplant?
A: Candidates for face transplantation need to have attempted other reconstructive surgery. The eligibility criteria are available here. Candidates undergo medical and psychiatric evaluation to assess for health, social support and ability for self-reliance and compliance of physician directed care.
Q: What are the ethical concerns of a face transplant?
A: The surgical procedure is long and not without risks. There is a risk of rejection after the transplant.
The recipient of a face transplant will take life-long medications to suppress the immune system and fight off rejection. The immunosuppressive (anti-rejection) medications will need to be taken for life. These medications can lead to infection and other complications.
There are some experts that question the risk associated with face transplantation as it is not a life saving operation. However, the candidates with facial disfigurement live with social isolation and fear of rejection from their appearance affecting their quality of life.
Q: What is the risk of the recipient's immune system rejecting the new face?
A: All patients undergoing transplantation will take anti-rejection medications for life. Every patient has an episode of rejection, which may manifest itself as a change in color, patchiness, swelling, and/or a rash. Anti-rejection medications can be increased or additional medications can be added to treat rejection that is diagnosed early.
Q: What if the transplant fails?
A: Anti-rejection medications will be needed to prevent rejection. However, other reconstructive procedures using tissues from the patient's body (such as skin grafts) may be used in the event the transplant is not successful.
Q: What should the candidate expect over the first year after transplant?
A: The skin incisions and swelling will heal over the first months. During the first year, the feeling and function will start to return to the face with therapy and exercise.
Q: Will the candidate look like the donor after face transplantation?
A: Although there may be a resemblance, the underlying facial structure of any two people is different and provides the opportunity for the candidate to appear different from the donor. A person's appearance is also influenced by expression and facial movements.
The donor/recipient match will be assessed on blood type, gender, age, skin color and age.
