Face transplant surgery

November 27, 2002 7:13 AM

Face transplant surgeryappears to be nearing reality. A conference taking place this week will discuss the issue, which is not without controversy. How would you feel about a loved one who had been severely disfigured getting a new and different face? Would you be willing to donate your face after you had died?
posted by CoolHandPuke (32 comments total)

The scary part about this, is that I had a dream about face transplants last night... Eep! (Don't ask, I have weird dreams.)
posted by Dark Messiah at 7:16 AM on November 27, 2002

A separate team of surgeons would remove, or 'de-glove', the face, facial muscles, skin and subcutaneous fat from the recipient.

My new word for the day.
posted by gottabefunky at 7:19 AM on November 27, 2002

I think this young lady talked about in an earlier thread should be one of the first in line (somewhat graphic pic).
posted by CoolHandPuke at 7:19 AM on November 27, 2002

Could science make Nicolas Cage look like John Travolta, and then make John Travolta look like Nicolas Cage? And could we put both of them, with their respective new faces, onto a bus and drive it over a cliff? Please?
posted by Danelope at 7:21 AM on November 27, 2002

Not that I know anything about this, but it seems to me that you wouldn't necessarily look all that different, since the doctors aren't doing anything to the fundamental bone structure.
posted by LittleMissCranky at 7:28 AM on November 27, 2002

Science is really gross sometimes.
posted by Samsonov14 at 7:43 AM on November 27, 2002

Am I the only one thinking that Michael Jackson should be the first recipient?
posted by konolia at 7:52 AM on November 27, 2002

I think I would be able to donate my face - it's just skin...the person would probably not look like you at all, unless you had a very distinctive birthmark or something. The only thing would be if family needed more time to look at you and grieve, instead of a quick good-bye at the hospital, but I think I would be ok with it.

This post reminded me to order a donor card in the mail, thanks!
posted by agregoli at 7:53 AM on November 27, 2002

Oh great, another option for Michael Jackson
posted by ElvisJesus at 7:55 AM on November 27, 2002

I might donate it - but I'd be surprised if anyone wanted it.
posted by orange swan at 8:23 AM on November 27, 2002

To get all those feeder vessels anastomosed and tendons routed in between would just be an enormous task. I admire anyone who could do it. Yes, you bet the recipient would have some ikeness to the donor, considering this is more than skin, it is also muscles and subcutanous fat.The article refers to public approval being required. Is this some feature of the British public insurance system?
posted by planetkyoto at 8:29 AM on November 27, 2002

How much does bone structure play a part? Would donors and recipients have to match up on certain facial measurements and head size, or would it stretch to cover?
posted by agregoli at 8:34 AM on November 27, 2002

What they'll do next, see, is they'll recover some guy from the wreckage of a horrible accident, then reconstruct his face and give him a talking car. Then the guy will travel all over the country fighting evil with his spiffy-looking talking car. Gosh, it'll be great.
posted by NedKoppel at 8:47 AM on November 27, 2002

Am I the only one thinking that Michael Jackson should be the first recipient?

No. That's the first thing that popped into my head too.
posted by SisterHavana at 9:05 AM on November 27, 2002

I would have no problem donating a face. My face is not me. (Brain donation, now, might be a different issue.) For some years in San Francisco I commuted on a bus with a man with no face. Just a normal man in a business suit carrying a briefcase--but what emerged from the collar of his neat white shirt was the stuff of horror movies. I assume it was a motorcycle accident, since the part of the head that would have been covered by a helmet was unburned. I do wonder sometimes what happened to him. If the new procedure can help him, I'm all for it.
posted by SealWyf at 9:07 AM on November 27, 2002

As an emerging medical procedure, face transplant surgery appears less controversial than xenotransplantation. I guess the fear about facial transplant, if indeed it becomes possible to transplant a just-dead person's facial organ(s) onto a patient who's suffering serious facial disfigurement from an accident or illness, is the outward result such transplant may produce in the patient. One can imagine that most would-be donors will have little qualms with donating their corneas or ear-drums for restoration of eyesight & hearing respectively in suitable patients, they will not be so forthcoming if they are advised that the use of donor's face organs may result in marked facial resemblances to the donors. However, I do not think any patient or surgeon will want to "create" a donor's lookalike, and since, a face transplant is primarily a reconstructive surgery, the "cosmetic" element will probably be part of the surgery process. But, as in all types of transplants, there are risks of organ rejections. That is one of the many reasons cloning supporters are in favor of human cloning.
posted by taratan at 9:08 AM on November 27, 2002

I think it would be fantastic, restoring many lives. Bush will never allow it though, in case some terrorist somewhere were to kidnap Ari "the Worm" Fleischer and use his face to gain access to the White House.
posted by rushmc at 9:13 AM on November 27, 2002

I would have no problem giving my face away with some one looking like me. I get the you like such & such routine already, at least this person with my face could experience this fun too. And it 's not just 1 or 2 people, but many that's why I'm for it. He would just add to the folks I look like.
posted by thomcatspike at 9:16 AM on November 27, 2002

That's "looked like", thomcatspike.
posted by orange swan at 9:38 AM on November 27, 2002

It's gonna get mighty creepy in the future.

Someone living with my face 20 or 30 years after I'm gone?

*shiver*

This sounds like a Twilight Zone episode. A man is horribly burned in an auto accident. He's given a new face by science... but what he doesn't know is, the face is from a famous mass murderer or child molester! Everywhere he goes, people try to lynch him or kill him.

On second thought... bad idea.

Okay, so this is ground-breaking stuff now. It will be used for good, I'm sure. But what about 100 - 150 years from now, when replacing a face is as simple as changing a tire? Get a new face when your old one gets wrinkled? Wanna be an Asian this year? Graduation present for your ugly teenage daughter?
posted by BobFrapples at 9:38 AM on November 27, 2002

I think the most interesting thing is what will we be burying in the future, when people donate themselves? Soon, it seems they will be able to use almost every bit of you to benefit someone else.
posted by agregoli at 9:42 AM on November 27, 2002

This takes recycling to a whole new level.

What I wonder about is how the faces will age.
posted by orange swan at 10:52 AM on November 27, 2002

I think it's vastly overstating reality to say that the recipient will look anything like the donor did. What's really being donated is more or less a sock made of skin, muscles and fat, which, when placed over the skull of someone with severe facial tissue trauma, will give them more or less their own face back. The skin colour and details, fat distribution and muscle size will be different, and will make them look different than they did before, but they'll probably still look more like themselves (pre injury) than the donor. It's not the face that's being donated as much as the parts which make up a face, the final appearance of which is mostly determined by underlying bone structure, not the soft tissue which overlays it. Someone won't be "living with your face", they'll be living with the bits and pieces of soft tissue which were used to make up your face.
posted by biscotti at 11:24 AM on November 27, 2002

biscotti, thanks for ruining our fun with your reasoned and sensible and informative comments. Just when I was going to say "I get Kate Winslet!", too.
posted by jokeefe at 11:36 AM on November 27, 2002

Just line up, today's Wednesday, Soylent Green day.
posted by pjgulliver at 11:49 AM on November 27, 2002

This isn't entirely new ... nearly 20 years ago when I was a lad working at a small hospital in the mountains of New Mexico, one of our cooks was thrown through the front windshield of her car when she hit a patch of black ice on the road. She slid, face-down, on the pavement for about 15 feet and her face was nearly completely ripped off. It was literally hanging by a mere strip of flesh on her chin.

She was flown to UNM in Albuquerque, where plastic surgeons worked on her for a really long time and they were able to reattach her face ... leaving only a rather noticeable scar on her chin and an almost invisible series of scars on her forehead.

It was the most amazing piece of work I think I've ever seen in my entire career working in the healthcare industry. To think that this type of operation is entering the realm of the everyday will be of benefit to all such accident victims, and more people besides.
posted by WolfDaddy at 12:07 PM on November 27, 2002

I think this is great news, wonderful if they can pull it off. (pun?)
I think a lot of people underestimate the ways that 'appearance' surgery can be so wonderfully lfe-changing. I know I did, until this year, when I finally got my mammoth, broken, useless chest reduced. I can run fast enough downhill now to get those ripped-up jeans and scarred knees back that I had at twelve. And I don't wake up in the morning with my spine out of place. All this and more from a relatively simple operation. I can't begin to imagine the joy that having a face back would bring. So yes, I would proudly donate my face, as easily as my heart or liver.
As for 'public concern', what right does 'the public' (erch) have to a say in the matter, if the donor has given prior permission, and the patient is aware of the risks? I'm sure 'the public' (retch) was originally anti heart transplants too.
posted by Catch at 12:27 PM on November 27, 2002

Well I guess the question needs to be asked?

At what point do they take the face from the original holder?

After they're dead, and starting to dry out (rout)?

or

While they're still walking around?

Organ transplants are very time sensitive
posted by WLW at 5:36 PM on November 27, 2002

The skin colour and details, fat distribution and muscle size will be different, and will make them look different than they did before, but they'll probably still look more like themselves (pre injury) than the donor.

it seems like those muscle and fat distributions have a lot to do with how a face look though - look at the pic of that woman who had over 40 surgeries since her face was basically burned off (or consider that motorcycle accident man referenced above) - they have the same bone structure they always had, no? I'd guess it would be some kind of combination, but you have to admit, you don't see skulls and recognize who they are.

facial recognition is actually apparently a specific ability which some people don't have - objectivel a face is not more specific than a hand, eg, but we don't generally recognize people's hands as easily.
posted by mdn at 6:44 PM on November 27, 2002

Want to learn more about losing your face? Try Invisible Monsters. From the guy that wrote Fight Club.
posted by sophist at 7:02 PM on November 27, 2002

you have to admit, you don't see skulls and recognize who they are.

No, but the underlying bone structure is what gives the overall shape and impression of the face. Of course, if you remove the overlying tissue (as happened with the burned woman, who lost a substantial amount of tissue), you don't see a face, and if you change it substantially, you change the face (which I alluded to in my original comment), but it's the bone structure which provides the basis for your face, which is why forensic reconstructions based on skulls are often very accurate when compared to photographs. All I mean is that the recipient of the transplant is likely to look more like themselves pre-injury (no matter how different) than the donor, this isn't going to be like Face/Off. The donated face has to fit over the underlying structure, and will be affected by that structure, like putting a sock on a foot, it's not the sock that gives the basic shape, no matter how much padding it may have, it's the foot.
posted by biscotti at 8:38 PM on November 27, 2002

I might donate it - but I'd be surprised if anyone wanted it.
My first thought too. Reminds me of when a friend of mine was injured in a boat racing accident and his girlfriend was asked to bring in a photo so the doctors could do some reconstructive surgery, so she gave them a photo of Tom Selleck.

I can't see how anyone could have a problem with donating their face any more than any other body part and I can't see why people have a problem with giving away something that they are not and will never use. Simple selfishness (genuine religious belief aside).
posted by dg at 10:30 PM on November 27, 2002