Dr. David Bottger has established himself as one of the foremost experts of plastic and hand surgeries in the Newton, Pennsylvania, area. Working on changing peoples’ appearances is a part of Dr. Bottger’s business and he has a near encyclopedic knowledge of cosmetic procedure. With breakthroughs in cosmetic surgery continuously surging forward, Dr. Bottger has to stay abreast of the latest advancements to his craft. The technology of plastic surgery evolves constantly: What was merely imagination becomes possible with each new procedure. Below, Dr. Bottger outlines a procedure recently performed successfully for the first time.
Do you remember the Jon Woo film, Face Off? In case you never saw it, the movie chronicles an FBI agent, John Travolta, and a terrorist, Nicholas Cage, who swap physical characteristics. In a futuristic medical procedure, Travolta and Cage actually swap faces as each actor playing the role of the other. When the film was released in 1997, the concept of a face transplant was complete science fiction. Recently however, a team of eight Cleveland Clinic surgeons did just that and completed the first facial transplant ever in the United States. A severely disfigured woman, who was unable to speak, taste or smell, underwent a near total face transplant. The face used belonged to a female cadaver who had donated her body to science. Over the course of the 22-hour surgery, the team fixed the severe deformity in the middle of her face which included a missing jaw and a missing right eye.
Prior to the surgery, the patient suffered from immense social awkwardness and fears. She was often bullied, called names and humiliated. Due to her disfigurement, the patient simply could not live a normal life. Now, thanks to a great surgical team and advancements in the field of cosmetic surgery, she can enjoy the same social freedoms as everyone else.
Over the course of the various procedures, the patient underwent surgery on over 80% of her face. The transplanted donor face had to be shifted into position which entailed skin grafts, bone graft, nerve surgery, muscle connecting, blood vessel and arterial connections. Ultimately, only the patient’s chin and forehead were left intact. Now, for the first time ever, the patient has a good chance of being able to smell, blink and move her face with the same muscular complexities that are typical of facial functions.
And while the possibility existed that the body would reject the transplanted face, doctors have been pleasantly surprised to note that thus far everything remains fine. (The patient will have to take medication that suppresses her immune system’s natural inclination to reject the transplanted face.)
Though this was the first successful face transplant in the United States, it was not the first such surgery. Facial transplant surgeries had previously been completed successfully in both France and China over the past three years. Generally the recipients of these procedures were victims of extreme physical traumas and injuries. The recipient of the surgery in France was attacked by a dog, which left her face disfigured. The Chinese recipient of a face transplant was a similar story, having been attacked by a bear. However, the Chinese case was not entirely successful, as the recipient died later on of unknown causes.
The process of facial transplants has come under some controversy by the medical community as a whole. Rejection of the transplanted face is likely and the risks of such a procedure are deemed too great by some to justify its undertaking. Many critics of facial transplants argue that since the procedure is not used to treat life-threatening conditions, it should not be practiced, in light of the extreme danger it presents.
But as a cosmetic surgeon, I understand firsthand the difference between a life-saving procedure and one that saves quality of life. Someone who is so badly disfigured that he can’t see comfortably or step outside without fear of ridicule is hardly living a life at all. It is very hard, if not impossible, to adjust to a life like this. A facial transplant is a complex, difficult and dangerous procedure, but the Cleveland Clinic has thus far had success with its facial transplant patient. As of this writing, the patient is healthy and hopefully will remain as such. Adapting to her new face may prove to be a challenging journey, but one that allows her to lead a normal and productive life.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
