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Science Technology

First Face Transplant 446

Posted by ScuttleMonkey from the doctors-facing-off dept.
mriya3 writes to tell us the BBC is reporting that surgeons in France have performed the first ever face transplant. The medical team, led by Jean-Michel Dubernard, transplanted live tissue to a 36-year old woman whose face had been destroyed by a dog. From the article: "It has been technically possible to carry out such a transplant for some years, with teams in the US, the UK and France researching the procedure. [...] But the ethical concerns of a face transplant, and the psychological impact to the patient of looking different has held teams back."
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First Face Transplant More

First Face Transplant

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  • Well, whose face did she get? (Score:4, Funny)

    by jonnythan ( 79727 ) on Wednesday November 30, 2005 @12:13PM (#14148181)
    Was it John Travolta's or Nicholas Cage's?

    I wouldn't want either.

  • Ethical concerns? (Score:5, Insightful)

    by Eric Smith ( 4379 ) * on Wednesday November 30, 2005 @12:13PM (#14148190) Homepage Journal
    What ethical concerns?

    A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

    And how could the "psychological impact" be worse than not havin a face? The patient is going to "look different" no matter what is done.

    • Re:Ethical concerns? (Score:3, Interesting)

      by supra ( 888583 )
      > Where's the problem?
      What if a person commits a crime and uses this surgery to escape identification and/or conviction.

    • Re:Ethical concerns? (Score:5, Insightful)

      by Chmarr ( 18662 ) on Wednesday November 30, 2005 @12:17PM (#14148235)
      Yeah, I thought that was kind-of daft too.

      "Oh, I can live with having a mauled/disfigured/destroyed face, but I CANT live with having someone ELSE's face".

      Yeah... right.... :)

      However, doing the ID thing would be interesting from then on.

      • Re:Ethical concerns? (Score:3, Insightful)

        by Scoth ( 879800 )
        Some people consider their identity to be extremely personal, including their appearance. I know a few people who would likely prefer "Disfigured, but it's me!" over "some other guy". I personally would probably go with the transplant if the situation ever came up, but it's definitely not a universal assumption to be made.

    • Re:Ethical concerns? (Score:5, Informative)

      by Darkon ( 206829 ) on Wednesday November 30, 2005 @12:17PM (#14148241)


      A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

      From the article:

      "Where donors would come from is one issue that would have to be considered. "The transplant would have to come from a beating heart donor. So, say your sister was in intensive care, you would have to agree to allow their face to be removed before the ventilator was switched off. "And there is the possibility that the donor would then carry on breathing."
      • Couldn't we use Japanese for donors? Don't they lose face all the time?

        /ducks



      • Looks like a job for Gil the ARM.

      • Re:Ethical concerns? (Score:5, Informative)

        by mgv ( 198488 ) <Nospam.01.slash2dot@veltman. o r g> on Wednesday November 30, 2005 @04:39PM (#14150816) Homepage Journal
        "Where donors would come from is one issue that would have to be considered. "The transplant would have to come from a beating heart donor. So, say your sister was in intensive care, you would have to agree to allow their face to be removed before the ventilator was switched off. "And there is the possibility that the donor would then carry on breathing."

        This doesn't happen if the brain death testing is done properly. In Austraila one of the tests for brain death is that the person is disconnected from the ventilator for 20 minutes. If they breathe, they aren't truly brain dead. If you have proper criteria for brain death - A known cause of brain injury, meet several inclusion criteria (such as the aponea test mentioned above) and don't have any exclusion criteria that can look similar (eg recent anaesthesia/ low body temperature) then you can be considered as an organ donor.

        In reality, people without brainstem function are very hard to keep alive on a ventilator, because the brain regulates alot of things. For example, the brain constantly releases a constant stream of anti diuretic hormone from the pituitary gland to regulate the total amount of water in your body. With brain death this stops and the kidneys will produce the maximal amount of urine (20+ litres/day), so fluid balance fails drastically.

        I have seen less experienced people not understand the proper definition of brain death - I think that this is where you get the stories about turning off ventilators and people surviving. Brain death is a rapidly termainal condition. That is why so many heart transplants are done in the middle of the night - its hard to keep the donor alive until even the next morning.

        Just FYI

        Michael

    • Re:Ethical concerns? (Score:3, Informative)

      by drinkypoo ( 153816 )
      RTFA (I know, I must be new her), the face has to come from someone with a beating heart. The issue is that it has to be taken from someone on life support, who might then continue breathing on their own (without a face!) when the system is shut down.

      • Re:Ethical concerns? (Score:5, Insightful)

        by Eric Smith ( 4379 ) * on Wednesday November 30, 2005 @12:22PM (#14148306) Homepage Journal
        The article failed to explain why it couldn't be someone that died very recently (within minutes). In a hospital, there are people dying all the time, so finding a donor that isn't on life support doesn't seem completely impossible. Just somewhat difficult.

        • Re:Ethical concerns? (Score:4, Funny)

          by Oliver Wendell Jones ( 158103 ) on Wednesday November 30, 2005 @01:18PM (#14148920)
          The article failed to explain why it couldn't be someone that died very recently (within minutes). In a hospital, there are people dying all the time, so finding a donor that isn't on life support doesn't seem completely impossible. Just somewhat difficult.

          "Hey, little Timmy, we've got good news and bad news. The good news is someone just died a few minutes ago so you're getting a new face. The bad news is the person who's recently died is a 96 year old {insert optional racial type of your choice} woman..."

    • Re:Ethical concerns? (Score:5, Informative)

      by Pudusplat ( 574705 ) on Wednesday November 30, 2005 @12:18PM (#14148255)
      You obviously did not RTFA. The donor cannot be dead for this transplant to be successful. The donor would supposedly be someone close to death on life support. The surviving relatives of the "near deceased" would have to give the go-ahead to rip off the face of their beloved, assuming they will no longer need it. This could presumably lead to problems if a miraculous recovery of the donor happened or could adversly affect the donor's family if they see the face of their relative on someoene else's head. Those are the ethical concerns.

      • Re:Ethical concerns? (Score:3, Interesting)

        by dada21 ( 163177 ) *
        This is the wonderful aspect of the free market when it comes to ethics: you are completely free to live your life believing in the ethical angles you believe in, and allow others to do the same without affecting your ethics or theirs.

        If a doctor wants to perform this surgery for a patient that wants it, awesome!

        I do believe we need to see a change in how parts are donated, though. Honestly, I would love to say "If my family can get $x,000 for this part and $xx,000 for that part when I am brain dead, then
        • I hate the fact that hospitals can make hundreds of thousands of dollars over a transplant's life (anti-rejection drugs, therapies, surgery, actual sale of the organ) and the person it was taken from is left with jack for their family.

          Problem is the person making the decision to pull the plug (and cut off your face and other organs) would have a financial incentive to do so. Of course, they could already hate you.

        • Your sig... yes, your right. I do miss it. Gonna have to get it setup again now that you've reminded me. Thanks.

      • Re:Ethical concerns? (Score:2, Interesting)

        by Gr8Apes ( 679165 )
        As for seeing "the face of their relative on someone else's head" wouldn't be any different than seeing someone else that looks like their relative. After all, aren't organ donations anonymous in the general case? So how would they know this is "the one"?
    • You wouldn't find it weird to get up one morning and have somebody else's face then?

      Even if we say that's a-ok, because the doner is dead and this is giving somebody who's presently got no face a face.. What if you meet their family in passing? What happens when face transplants move out of this arena and into the plastic surgeon's box of tools?

      Faces are hugely important to our interactions with the world, and our own self image - more than anything else (DNA, finerprints, retinas, etc.), your face is y
      • The resulting face is different from the donnor and also different from the receiver one. The cranium is very important to define features of the face, that's why it is possible to get a skull from someone who died a few years to even 1000s of years ago and reconstruct and make it within reasonable recognition.

        Off course that other factors that do not depend on the skull it self are going to be the same from the dead doonor, so the face will have some characteristics of the donnor and some of the receiver.

    • Re:Ethical concerns? (Score:3, Insightful)

      by garcia ( 6573 )
      A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

      According to the article, that you apparently didn't read: "In the controversial operation, tissues, muscles, arteries and veins were taken from a brain-dead donor and attached to the patient's lower face."

      "Brain-dead" doesn't mean the donor wasn't alive.

      It added that the woman - who wishes to remain anonymous - was in "excellent general health" and said the graft looked normal.

      This was nothing more than a skin
      • This was nothing more than a skin graft. If it weren't for the "ethical implications" of taking someone else's healthy tissue from their *face* this would have been a non-issue.
        ... because we all know that if you try to graft skin from another large smooth area, say the rear end, they'll end up butt-ugly.

    • Re:Ethical concerns? (Score:5, Informative)

      by darkmeridian ( 119044 ) <william.chuang@NOSPaM.gmail.com> on Wednesday November 30, 2005 @12:28PM (#14148374) Homepage
      Technically, face transplants are not medically necessary. The surgery would definitely make the person feel better, but it is not life-saving such as heart, liver, lung, or kidney transplants. The side effects of immunosuppresants are still quite severe and perhaps life-threatening, since the immune system is getting shut down for the life of the patient. The question is whether a doctor can allow someone to take these risks for a non-life-saving procedure.

      Living donors are not a problem because they're brain dead. So cutting off someone's face is scary; do so while they're still breathing (via ventilator) is really creepy. Yet, we pull hearts out of living people already so what's the face?

      • Re:Ethical concerns? (Score:2, Insightful)

        by pdamoc ( 771461 )
        Technically, face transplants are not medically necessary. From a physiological point of view you are right BUT we are both physiologic and psychological beings. When healing the healer tries to improve one, the other or both. A patient without a face might be at a very low psychological level even if from a physiological point of view she is ok so... healing is needed.
      • Technically, face transplants are not medically necessary.

        Well according to the article, she couldn't speak or eat properly. (Okay, I don't eat properly, but that is by "choice", sort of.)

        That would be pretty close to medically necessary. It's not strictly "cosmetic".

    • Like hell I would have anything from a dead person put on or in me.
      I had surgery last year and they wanted to put bone marrow and bone fragments in me from an UNKNOWN DEAD donor.. Like hell. I opted for a different type of surgery that where they used my own bone fragments for the fusion.

      I also donated blood to my ownself in advance so that I would have it if I needed it. With all the fonky diseases they keep coming up with there is no way in hell I will accept body parts or fluids from another person, e

      • Re:Ethical concerns? (Score:4, Insightful)

        by ScentCone ( 795499 ) on Wednesday November 30, 2005 @01:28PM (#14149019)
        Wull, mghuh-hmm-srtch-hmmm.

        Sorry, I couldn't quite get that out - I was finishing a hamburger. You know, putting some foreign tissue into my body. I think it's pretty obvious why... wait... [smack!]. Sorry, I had to swat a mosquito. It was busy getting some of its fluids into my body. In fact, that reminds me of how I was in an elevator this morning respirating the same damp air as the other ten people in there. Other people's exhalations, microbes, viruses and all!

        Look, you stand way more of a chance of getting a disease from sitting on a public toilet than you do from a highly scrutinized tissue transplant. In fact, you could just as easily die from an anti-biotic-resistant lung infection picked up environmentally while you're in the hospital having your own blood transfused back into you.

        I think you doth protest too much, and that your issue is strictly a superstitious one, similar to those that prevent people from donating their loved ones' perfectly good organs after an accidental death. I'm always amazed that people would rather bury a good liver in the ground (or burn it) than let some poor kid get a new lease on life. But I'm even more amazed by someone who would rather die than take in an organ from a screened donor. That's OK though - helps us evolve more rational people.

    • Re:Ethical concerns? (Score:5, Interesting)

      by SilverspurG ( 844751 ) * on Wednesday November 30, 2005 @12:37PM (#14148471) Homepage Journal
      The ethical problem is with the doctor. Existing technologies are sufficient to reconstruct the face without the need for immunosuppressants for the rest of the recipient's life.

      Transplanting a face is a PR stunt and MAYBE an academic exercise. It should not be standard treatment procedure. The article, by citing "10,000 burn patients in the UK", is trying to trump this sort of thing up to standard procedure.

    • Re:Ethical concerns? (Score:4, Insightful)

      by tomhudson ( 43916 ) <barbara.hudson@b ... m ['on.' in gap]> on Wednesday November 30, 2005 @12:41PM (#14148517) Journal
      and the psychological impact to the patient of looking different

      It doesn't take much brains to realize that someone's going to look different after having their face chewed off by a dog. I should think having a strangers' face is less traumatic than seeing your own looking like a barfed-up big mac.

      Better a stranger's face than a strange face.

    • Well, it's less ardous than being given back your old nose, that's for sure.

  • In other news... (Score:3, Funny)

    by Penguinoflight ( 517245 ) on Wednesday November 30, 2005 @12:15PM (#14148210) Journal
    The team of surgeons deny that The Silence of the Lambs [imdb.com] played any influence in their technique.

  • I'm confused.. (Score:5, Insightful)

    by RapmasterT ( 787426 ) on Wednesday November 30, 2005 @12:15PM (#14148214)
    No seriously, what exactly are the "ethical considerations" of a face transplant? What makes it more ethically significan't than a skin transplant anywhere else?

    And the "psychological impact" to the patient of looking different?? Looking different from a hideously scarred accident victim? Isn't that why they want surgery in the first place?

    This seems to me like a story desperately in search of sensationalism.

    • No seriously, what exactly are the "ethical considerations" of a face transplant?

      Ever seen the faces on the post office wall? Or on the side of a milk carton? Or mug shots or headshots used in a pictorial line up or even a real line up?

      There is little ethical consideration for getting your bobbies bigger. But doctors would be up against a pretty big wall if they had to choose whether or not to completely change somebody's face.

      • Re:I'm confused.. (Score:3, Insightful)

        by RapmasterT ( 787426 )

        Ever seen the faces on the post office wall? Or on the side of a milk carton? Or mug shots or headshots used in a pictorial line up or even a real line up?

        Ok, I gotta ask.

        What the hell are you talking about? What does any of that have to do with face transplants?

        Are you suggesting criminals would use this to hide from prosecution? Not only is the appearance change likely to be minimal (since the bone structure is the same), but nothing stops them from having plastic surgery RIGHT NOW.

        You sound li

      • >> Or mug shots or headshots used in a pictorial line up or even a real line up? There is little ethical consideration for getting your bobbies bigger.

        Of course I'm sure officer! I'd recognize those breasts anywhere!

    • Re:I'm confused.. (Score:5, Interesting)

      by Have Blue ( 616 ) on Wednesday November 30, 2005 @12:35PM (#14148460) Homepage
      The face isn't just an organ, it's a large part of your personal identity and how you distinguish yourself from the rest of the world. It's the only part of the body that is almost universally exposed to general scrutiny, and it's how you are known by others. I'm no psychologist, but I can imagine there's a difference between looking in a mirror and saying "that used to be me", no matter how mangled you are now, and looking in a mirror and saying "that is someone else".

      The ethical implications would come from the process of removing the identity from someone who may or may not be dead and effectively erasing the identity of the recipient when the transplant is complete and he looks like someone different.

      • Re:I'm confused.. (Score:3, Informative)

        by truesaer ( 135079 )
        The ethical implications would come from the process of removing the identity from someone who may or may not be dead and effectively erasing the identity of the recipient when the transplant is complete and he looks like someone different.

        Actually, I read about them considering doing this a few months back. Apparently your face looks like your face mostly due to the particular's of your underlying bones...so if you get a face transplant you actually look pretty much like you did before. Obviously some de

      • Re:I'm confused.. (Score:5, Interesting)

        by Bastian ( 66383 ) on Wednesday November 30, 2005 @01:29PM (#14149029)
        I'm no psychologist, but I can imagine there's a difference between looking in a mirror and saying "that used to be me", no matter how mangled you are now, and looking in a mirror and saying "that is someone else".

        Luckily, a lot of your appearance comes not from the soft tissue of the face, but from the underlying bone structure. A person who gets a face transplant wouldn't have the same visage as they used to have, but they wouldn't have the visage of the donor, either.

        I would assume that the "looking in the mirror" problem would be no greater for a face transplant recipient than it would be for a person who experiences some other massive change to their face, such as whatever damaged it so much in the first place or reconstructive surgery.

    • Re:I'm confused.. (Score:5, Insightful)

      by BarryNorton ( 778694 ) on Wednesday November 30, 2005 @12:40PM (#14148506)
      No seriously, what exactly are the "ethical considerations" of a face transplant?

      And the "psychological impact" to the patient of looking different?

      It's about having, to some degree, someone else's face.

      This is also why they're at pains to point out that the recipient does not look exactly like their donor.

      Just as people look back and can't understand why people were uncomfortable with the idea of someone else's blood running around their veins, or someone else's heart beating in their chest, so people might get over this idea - you apparently have.

      Have some imagination, though, and see why people have (it's true, and well-documented, not just sensationalism) been creeped out by this idea for decades...

    • The ethical considerations is that the doctors participating in this are using it as a PR/media stunt. With current existing tissue engineering and plastic surgery technologies it is not necessary to perform a face transplant and subject the recipient to long-term immunosuppressants.

    • Re:I'm confused.. (Score:3, Informative)

      by dtfinch ( 661405 ) *
      The face was taken from a LIVE donor.

  • Best of both worlds (Score:3, Funny)

    by konaforever ( 744753 ) on Wednesday November 30, 2005 @12:16PM (#14148219)
    Now I can be good looking and smart!

  • In other news (Score:4, Funny)

    by ankarbass ( 882629 ) on Wednesday November 30, 2005 @12:16PM (#14148223)
    Michael Jackson is in france this week for an undisclosed medical procedure.
  • From 2002 [cnn.com], and 2004 [cnn.com]. I'm a little suprised this happened in France first, as the 2004 article expressed interest in moving forward with this at the University of Louisville.

  • Face Jacking? (Score:3, Funny)

    by KrackHouse ( 628313 ) on Wednesday November 30, 2005 @12:17PM (#14148239) Homepage
    I've heard the rumors of organ snatchers where you wake up in a bathtub with stitches and one kidney. Should we incredibly good looking people fear knife weilding hoardes of uglypeople hell bent on revenge?

  • yuck (Score:4, Interesting)

    by machine of god ( 569301 ) on Wednesday November 30, 2005 @12:17PM (#14148244)
    they can't reconnect the nerves can they? Wouldn't it feel like having a thick layer of dead skin on your face all the time, I mean I'd want to pull it off continually.

    • Re:yuck (Score:3, Funny)

      by Mr2cents ( 323101 )
      With comments like these, could you please add "Warning: spoiler!!!" to the title? Thanks a lot for giving away the ending! Sheesh!

    • Re:yuck (Score:3, Interesting)

      by hackstraw ( 262471 ) *
      they can't reconnect the nerves can they?

      Not sure, but nerves have been reconnected in plenty of other procedures over the years.

      Wouldn't it feel like having a thick layer of dead skin on your face all the time, I mean I'd want to pull it off continually.

      People get sensitized to constant stimulation. Ever forgot that you had a hat on and had to use your hand to figure it out? Ever want to pull your hair off your head because there is a bunch of dead protein laying there?

      I'm not saying it might be weird or

    • You get used to it (Score:4, Informative)

      by Atario ( 673917 ) on Wednesday November 30, 2005 @02:56PM (#14149809) Homepage
      Having had a big swath of my forehead flesh disconnected from its nerves in a car accident, I can tell you that you get used to it. And, no, you don't want to pull it off. When it first happens, it's an injury and you do all you can to avoid touching it altogether. After it heals, you're used to not messing with it. By that point, you're accustomed to the way it feels anyway.

  • So that's how (Score:4, Funny)

    by hypergreatthing ( 254983 ) on Wednesday November 30, 2005 @12:18PM (#14148261)
    Bin laden got away from afghanistan with no problems. Now he's mascarading as Dick Cheney.

  • The doctors said they replaced the lips, nose, and chin. Sounds like half the people in Hollywood if you ask me.

    gasmonso http://religiousfreaks.com/ [religiousfreaks.com]
  • Don't believe it!
    A revolutionary medical technique allows an undercover agent to take the physical appearance of a major criminal and infiltrate his organization.

    Oh wait, is this a movie [imdb.com]? :)
  • I think growing human parts on animals is our best bet (like this mouse with a human ear on it) [blogger.com]. However mice would be too small for a whole face. How creepy would it be to drive by a herd of cows with human faces growing all over them???
  • "The ethical concerns of a face transplant...."

    Someone's already supposedly cloned a human embryo. I wouldn't worry about facial transplants too much.

  • you dont look the same (Score:4, Insightful)

    by jmazzi ( 869663 ) on Wednesday November 30, 2005 @12:23PM (#14148313) Homepage
    Even if you got a face transplant, you wouldn't look like the face of the donor. Your bone structure etc is what makes up most of your appearance. Although, you wouldn't like you use to. So I don't see how ethics would really take a roll in this matter.
  • "Eyes without a Face" by Billy Idol was heard playing in the background of the operating room.
    This was followed by "The Real Me" by the Who and the Pixies' "Broken Face."
  • It seems strange that they would have held back on this kind of proceedure because of concerns with psychological reactions to looking different. It would seem that there would be a number of people out there who would take a whole new face over the remains of one chewed off, blown off, or burned off...

    Or maybe there is more concern over the situation depicted in the film, "Face off"?

    For the people involved in the reconstruction, I hope it works out well.

    LoB

  • Thus come all of the stupid "Face/Off" replies. (Score:2, Funny)

    by Anonymous Coward
    Here we go. Time for all of the inane "Face/Off" replies as though no one else would have possibly thought of it. I guess that we should all just laugh hysterically and use the idiotic TripMaster Monkey anime smiles to make the Face/Off posters feel complete.

    [holding sides laughing] Oh, GOD! "Face/Off"! I would never have thought of that! Oh, that is SO-O-O-O funny! I'm laughing too hard! Oh, look! Another reference! Please! Stop![/holding sides laughing]

    There. I hope the "Face/Off" people

  • We can regrow ears ! (Score:4, Interesting)

    by zymano ( 581466 ) on Wednesday November 30, 2005 @12:29PM (#14148379)
    What is so difficult about a face but we can grow other parts.

    http://www.pbs.org/saf/1107/features/body.htm [pbs.org]
  • This could be urban legend, but a few years back some Mexican drug lord tried to get a face transplant and didn't survive long.

    Anyone else remember this?
  • I don't think (at least from my cultural background) that there is a concern with transplanting a face--it is just like any other donated organ. However, in many cultures the face has great significance that is deeply meshed into the sociological values and even linguistics of their lives. Many Native American languages, for example use the concept of the face to identify everything. For example the phrase --ru li che'--in the native American language of K'ekchi' literally translates as 'face of the tree
  • The 38-year-old French patient from the northern French town of Valenciennes underwent extensive counselling before her operation, which is believed to have lasted at least five hours...

    From the no hyperbole dept..

  • First ever? (Score:2, Funny)

    by hal2814 ( 725639 )
    I think not. [imdb.com]

  • Is there a doctor in the house? (Score:5, Interesting)

    by DG ( 989 ) on Wednesday November 30, 2005 @12:46PM (#14148565) Homepage Journal
    Given that skin cells are constantly being shedded and regenerating, wouldn't this (slowly) transform back into the recipiant's original face?

    Or would a skin sample from the transplant area show different DNA for all time?

    I'm genuinely curious. Is there a doctor in the house?

    DG
  • "and the psychological impact to the patient of looking different has held teams back."

    I would have thought that the patient would have had to confront that problem already.

    I dont see this being any different to major organ transplant, just the media having else to report.

  • Psychological impact? (Score:5, Insightful)

    by idommp ( 134503 ) on Wednesday November 30, 2005 @01:09PM (#14148823)
    I grew up with one-quarter of my face missing in action. When I was two, doctors removed the upper left quadrant of my face including the eyelids and the skin down to the bottom of my nose. Twenty operations and fifteen years later I finally got working (but not very pretty) eyelids again. The person undergoing the face transplant has already suffered the psychological impact of loosing their original face and the impact of being treated like some kind of monster. The trauma of getting a different face can't possibly be any worse.

    • Re:Psychological impact? (Score:4, Insightful)

      by Tim C ( 15259 ) on Wednesday November 30, 2005 @05:38PM (#14151525)
      The person undergoing the face transplant has already suffered the psychological impact of loosing their original face and the impact of being treated like some kind of monster.

      That really depends on the circumstances. I imagine that a lot of these operations would be performed immediately or very soon after the injuries were sustained (eg burns victims, etc). They may well still be adjusting to the idea of being disfigured, and - if the operation was performed soon enough - may not have had any contact with anyone other than medical staff, friends and family.

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