Our face is our identity. We smile, we express our sadness, we talk, our face helps us with all of these. Imagine, if a person's face is seriously damaged due to a serious accident, a burn, or some other medical condition? When the damage is so severe that even ordinary plastic surgery cannot repair it, how much will that person's life change? It is in such cases that we talk about a 'face transplant', which is a highly advanced and very complex solution in medical science. This is not something that is heard often, which is why we should be aware of it.
Simply put, what is a face transplant?
A face transplant is a surgical procedure in which facial tissue, in whole or in part, is taken from a deceased donor and transplanted into someone with severe facial damage. This is not like a normal operation. It is called a Vascularized Composite Allograft (VCA) . This means that everything is included, including skin, bone, nerves, and blood vessels.
This is a very rare and research-based surgery. Also, it is very difficult to find people who will donate a face. Therefore, to qualify for this surgery, you have to follow a very strict set of rules. Even after the surgery, you have to receive special medical care, physical therapy, and medications for the rest of your life.
Who is really suitable for this type of surgery?
This is not a surgery that everyone can do. To be eligible for this, the following points must be met. I will show this in a clear table.
| Qualification to be met | Description |
|---|---|
| Severe facial deformity | There must be severe damage (e.g. loss of nose, eyelid, lip) that cannot be repaired with normal plastic or reconstructive surgery. |
| Age | Must be between 18 and 60 years old. |
| Health status | You must not be pregnant and must be willing to avoid pregnancy for at least one year after surgery. |
| Existing diseases | There should be no serious infections such as HIV or Hepatitis. There should be no history of cancer or cardiovascular disease . |
| Habits | Smoking is not allowed. |
| Access to medicines | You must be physically and mentally able to take immunosuppressive drugs for the rest of your life. |
In fact, a person undergoes surgery like this not only to improve their appearance. The main goal is to restore basic life functions such as breathing, speaking, and chewing.
What happens before the surgery? This is a big process!
Before you are selected for this type of surgery, you will have to undergo a very thorough series of tests. This can be divided into three parts.
1. Examining the functioning of the body (Physiology)
Your doctor will check the function of your face and body. Your facial nerves and muscles need to be healthy enough to grow the nerves needed for the new transplanted tissue. Your body also needs to be able to handle this long surgery and the medications you will need to take for the rest of your life.
2. Physical examination
This involves checking your overall health, family medical history, medications you take, heart function, blood tests, X-rays, and CT scans . Most importantly, a 3D printed model of your skull is created using the CT scan images. This allows surgeons to plan the surgery very precisely.
3. Psychological readiness test
This is very important. Psychiatrists and social workers will talk to you and your family. Because the mental stress that comes with this surgery is immense. The public attention, the media attention, the time it takes to get used to a new face, all of this is a big challenge.
Imagine, in order for you to have a face, someone else has to die. It's not easy to live with this thought. But the donor's family often takes comfort in the fact that the death of their loved one gives someone else a new life.
Once you pass all these tests, you will be put on a waiting list for a face transplant. But finding a suitable donor is not easy. You may have to wait for months, maybe even years.
What happens during the surgery?
Once a matching donor is found, you will need to come to the hospital as soon as possible. The surgery may take up to 36 hours , not just 10 or 15 hours.
1. Removing the face from the donor: First, the medical team carefully removes facial tissue (skin, fat, muscle, nerves, blood vessels) from the deceased donor.
2. Preparing you: You will be anesthetized and your face will be prepared for surgery.
3. Vascular grafting: This is the most critical and complex part of the surgery. Using very small needles and threads, your blood vessels are connected to the blood vessels in the donor's face. This is what allows the transplanted face to receive blood flow and the tissue to survive.
4. Connecting nerves and muscles: Once blood flow is established, nerves are connected. This is what gives us sensations like touch, heat, and pain. Then muscles are connected, and this is what allows us to smile, talk, and blink.
5. Finishing: Finally, the bones are fixed with small screws and plates if necessary, and the skin and soft tissues are sutured.
What are the benefits and serious risks of the surgery?
Like any major surgery, this one has benefits as well as serious risks.
| Type | Description |
|---|---|
| Advantages | |
| Living conditions | Restoring basic functions such as breathing, chewing, speaking, smelling, tasting, and making facial expressions dramatically improves quality of life. |
| Risks | |
| Risks of surgery | Anesthesia complications, excessive bleeding, blood clots, infections, and even death can occur. |
| Transplant Rejection | Your body's immune system may recognize the transplanted face as "foreign" and begin to attack it. This is very dangerous. To prevent this, you will have to take immunosuppressive drugs for the rest of your life. |
| Infections | Immunosuppressant drugs reduce the body's ability to fight disease, so even minor infections can be very dangerous. |
Will I look exactly like the donor after the surgery?
This is a question that many people ask. No. You will not look exactly like the donor. This is because the skin and soft tissue that is transplanted is not changed, but the underlying bone structure of your skull remains the same. So you will have your own unique appearance. However, you may have spots, birthmarks, etc. on your new face.
Take-Home Message
- A face transplant is a very rare, complex, and high-risk surgery. It is only performed for severe facial deformities that cannot be corrected by any other treatment.
- The selection process for this is very rigorous, and it can take years to find a suitable donor.
- After surgery, you will need to take immunosuppressive medications for the rest of your life to prevent rejection of the transplant, which puts you at a very high risk of infection.
- This is more than just a cosmetic surgery, it is a life-changing procedure that restores basic functions such as breathing and eating.
- Strong mental health and family support are essential on this journey. It is very important to discuss all the factors thoroughly with your doctor before making any decisions.
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