Facial transplantation succeeded after incineration

Successful surgery helps man to a new face

07/12/2013

Two years ago, Dallas Wiens was the first American to receive a complete facial transplant. An accident at work three years earlier had burned his face. Physicians worldwide now benefit from the new findings of the OP.

Face burned by electric shock
In 2008, the Texan Dallas Wiens doctors prophesied that he would never speak again and eat properly. He would never be able to eat solid food because he could no longer produce enough saliva. The now 28-year-old had burned his eyes, nose, lips, chin, skin and muscles in an accident at work. But three years later, everything was about to change. The relatives of a deceased had agreed that Dallas should receive the face of the anonymous donor.

15-hour transplant
In March 2011, then transplanted a 30-member team of specialists Brigham and Women´In Boston, Massachusetts, California, the patient's nose, lips, facial skin, muscles, and nerves are treated in a fifteen-hour operation. It quickly became clear that the operation was successful and the Texan already showed up in public two months later. It was not possible to restore his eyesight, but since then Vienna has been able to breathe through his nose and smell, eat, smile and also feel the touch of his face.

Patient misses nothing except his eyesight
Just a few days ago, Vienna again appeared in the press and said at the Radiological Society of North America conference in Chicago: „My whole life is a miracle!“ He also said: „My life was very turbulent before the accident. I miss nothing - except maybe my eyesight. I learned a lot about other people and me. About my life as a blind man.“ The physicians also published information on the patient's development after the surgery for the first time. For example, pictures showed that just one year after transplantation, a new network of blood vessels had formed that connected the transplanted face to Vienna's tissue.

Findings could shorten the duration of future transplants
The radiologist dr. Frank Rybicki explained the sensational result: „It's the first time that this happened after a whole face was transplanted. This finding could shorten the duration of future facial transplants. These surgeries can take up to 30 hours, and involve connecting the patient's arteries, which are as thin as spaghetti, to the blood vessels of the donor tissue. Now we know that we only need to attach two facial or cervical arteries to each other instead of several. Face transplants using tissues from the dead are still in the experimental stage.“

Transplantation of own tissue as an alternative
If no foreign donor tissue is available, transplantation of own tissue is an alternative. But the success of this method, in which doctors remove skin from the back, buttocks or thighs and transplant it into the face, is limited, at least as far as the physical functions are concerned and also the appearance. A face restored in this way often retains a strong mask-like appearance. A facial transplantation with a foreign donor skin, however, meant a tremendous improvement in the quality of life for completely disfigured, faceless people.

First facial transplant in 2005
The French surgeon Jean-Michel Dubernand is considered a pioneer in transplantation medicine. In 1998 he transplanted a hand first and in 2005 he transplanted the then 38-year-old Frenchwoman Isabelle Dinoire the nose, cheeks and the mouth of a dead man. This surgery is considered the world's first face transplant to a living human. So far, there is little knowledge about how long a person can survive with a facial graft. For Vienna, who has to take medication for the rejection of the foreign tissue by the end of his life, it is already three years. And Isabelle Dinoire has been living for eight years with a new face.

Life after a tragedy
Vienna's doctors were already able to use their findings from the transplantation in other patients. Thus, they transplanted a donor's face to a woman after she was torn to pieces by a chimpanzee, and another patient also received a new face after being mutilated by her husband's acid. The doctor of Vienna, Frank Rybicki, wanted to motivate other families through the success story of the transplant, to release the face of a dead relative to the donation. Dallas Wiens agrees: „There is a life after a tragedy, if you really want it.“ (Ad)