Face-Saving Procedures?

by Jeannette Layne-Clark

It could be a scene from a science fiction movie - a patient being wheeled into some hospital's operating theatre to undergo a face transplant!

Film buffs would, no doubt, be familiar with the sci-fi production, Face-Off, in which a special agent - with the help of laser technology changes - faces with John Travolta.

Science fiction apart, just such a scenario is expected to become reality soon, as British plastic surgeon Peter Butler prepares to perform the world's first face transplant.

Those of us old enough to remember will readily recall reading, or hearing, the news of the first successful heart transplant performed by Dr Christian Barnard a few decades (could be about four - I don't remember how many) ago.

It seems eons since the South African surgeon nabbed international headlines for his stunning achievement. Since then, the transplanting of organs has, for developed (and some developing) countries, become a regular occurrence, a realistic, albeit expensive, option for patients depending on donors to save their lives.

But face transplants? What a ghastly thought! No wonder medical ethics campaigners are so vocal in expressing their abhorrence of Mr Butler's announced intention!

In an article published in a recent edition of London's Sunday Express newspaper, journalist Michelle Stainstreet reports on the amazing medical development, at the same time revealing doctors' fears of the dangers facing anyone undergoing the proposed surgery.

For the revolutionary procedure, the new face would, as expected, come from someone who has recently died. (Ugh!)

. . . The donor would be kept on a ventilator until minutes before being taken into theatre where surgeons would painstakingly peel away their entire face, including muscle tissue and skin.

"Simultaneously, doctors would remove any healthy tissue from the face of the patient to make it ready to receive the donor face".

Talk about brave new world! Apparently, the whole operation would take ten gruelling hours of "delicate micro surgery" to attach the graft, as nerve endings and blood vessels are reconnected to the recipient's face.

Mr. Butler's claim of a three to four per cent risk of death during the operation is considered "highly optimistic" by other surgeons opposed to the idea, even though they concede that there is need for the provision of the best possible care for people who are disfigured.

I must confess that I'm not exactly sold on the idea of living with the face of another person (and a dead one, at that!). To be blunt, I find it gruesome - and I simply can't imagine what the emotional fallout would be like.

Ms Stainstreet reports: "Mr Butler admits there is public resistance to the 'shocking concept of walking around with a dead person's face! But he claims the procedure is a straightforward and natural development of organ transplant technology' which has been used for many years successfully in Britain and around the world".

As for other organs which must be meticulously matched to lessen the chances of rejection, faces must also be carefully selected for patients undergoing the procedure.

But the news is that tissue matches would be much more difficult to check and the results of any rejection would be "devastating and most likely irreversible".

I don't know about you, but I find all this talk about face transplants to be more than a little spooky.

Yes, it is a significant coup for the British surgeon about to make it happen. But, for me, wearing a face that's not your own is strictly the stuff of science fiction - or, come to think of it, fancy-dress balls!

Copyright © 2001 Nation Publishing Co. Limited.

This article posted March 14, 2003.