Late last year, doctors in France performed the world's first partial face transplant, grafting a nose, lips and chin onto a 38-year-old woman who had been disfigured when her pet Labrador bit and scratched her face.  The lower two-thirds of her nose had been ripped away. Both lips were gone, leaving her teeth bared. The holes that were once her nostrils gaped open.  She retained her bone structure, her own tongue and her eyes.  The operation lasted for about five hours.  The donor whose features were used had committed suicide just hours before the operation.

The recipient, Isabelle Dinoire, did not look like her donor and did not look like the way she did before the attack. Instead, she had a new face which her doctors called a "hybrid" face.  The operation started with the removal of tissue from the female donor; then a triangular graft was placed on Isabelle’s nose and mouth. 

Prior to this remarkable operation, faces were reconstructed using thin grafts, and thicker flaps of skin and muscle from other parts of the body, such as the back; but the result was far from convincing and took more than 100 operations.

Months after the operation, Isabelle suffered a tissue-rejection episode that threatened to cost her her new face, but she recovered and is doing well.  Rejections happen because the human immune system is designed to attack anything it doesn't recognize. When your immune system finds cells in your body that don't possess the right MHC proteins, it tries to destroy them.

While Isabelle can eat, swallow, talk and even go out in a crowd without drawing a lot of attention, life after the operation has not been easy for her.  Isabelle said that staying inside her hospital room is tough, and not being able to do her normal chores for fear of infection requires a lot of adjustment on her part.  She's trying to be normal, but she took the wrong step towards a normal life--Isabelle started smoking again. Doctors fear this could interfere with her healing and raise the risk of tissue rejection.

The medical complications and psychological impact of face transplants has prevented other doctors from performing such procedures.  Studies and documents had already been presented for years before Isabelle's operation but the debate over its ethics continues.

The American Society of Plastic Surgeons (ASPS) and the American Society for Reconstructive Microsurgery (ASRM) recently unveiled a landmark joint document, called the Facial Transplantation-ASPS/ASRM Guiding Principles, to assist plastic surgeons considering participation in facial transplantation procedures.  The document considers the issue of facial transplantation by examining various subjects including, immuno-suppression, transplant rejection, technical issues and psychological aspects (both those facing all transplant patients and those unique to facial transplant patients). 

The document concludes with 10 Guiding Principles that a surgeon should consider before undertaking a facial transplant for a patient. The principles address such issues as appropriate patient selection; medical facility selection; patient’s informed consent; patient psychological evaluation; proper institutional oversight; and the ethics of the procedure.

This is my take on this issue:  face transplants should be performed on those who really need it.  Victims of fire and severe burns, accidents, cancer, and other attacks that cause facial disfiguration can undergo such operation provided that there is a healthy and willing donor. 

Preparing the patient is also very important.  It's not easy waking up one day to see a face you're accustomed to only to have it changed.  Prior to the operation, the patient should also know everything about the procedure--the outcome, the complications, the maintenance, etc.  Nothing should be withheld from them. 

What I fear about this procedure is this:  I don't want to see this technology applied to common use.  To improve their looks, people might opt for this type of procedure.  It's a very delicate operation that would require a prepared patient and an available donor (I just hope people will not sell their facial skin).  And let's say the operation is successful, will the new skin accept your beauty regimens, if any?  Can it withstand cosmetics, creams, lotions and others or will it bring complications?  How disciplined are you to resist it?  If you're not sure, better not do it.

With all due respect, I have nothing against those who have undergone medical procedures to improve their looks and personality.  But having a "second face" (not a second life) is a totally different ballgame all together.  As I've said, unless it's really necessary, people should be happy, proud and contented with what they have been given, rather than aspire for things they do not really need.

I’m logging off for now.  Stay cool and God bless us all!

********

Announcement: Attend the Powertips 2006 "Security Secrets and Strategies" conference on March 16, 2006 at the Grand Ballroom of Dusit Hotel Nikko.  Tickets are available at all SM TicketNet outlets or call 911-5555.  You can also register online at www.infochat.com.ph.

For your questions, comments, suggestions, press releases and stories, please e-mail techtvhost@yahoo.com or visit www.infochat.com.ph for more articles.