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What Face Transplants Can, Can't Do

Woman Mauled by Chimp Latest in Growing Number of Face Transplants
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When Face Transplant Is an Option continued...

"At least from reports we get, most transplant patients are happy to get back a normal human face," she says. "They are happy when they wake in the morning that they can feel a nose instead of a hole."

But for an operation performed on people whose lives are not in danger, it's an extremely high-risk procedure. Of the 17 patients known to have received face transplants, Siemionow says, two have died.

Balancing the risk are substantial potential rewards.

"Our patient, Connie Culp, before transplant did not have a nose so she was breathing through a tube in her neck. She did not have a palate, so she could not eat solid foods and used a feeding tube in her abdomen. She could not smell. She could not smile," Siemionow says. "But after transplant she can breathe through her new nose and also speak intelligibly and eat with the return of a normal palate. She actually is smiling, she is kissing her grandchild, she can make funny faces. It is amazing how great is her functional recovery."

What Happens During a Face Transplant

Exactly what gets transplanted from the donor to the recipient during a face transplant depends on the needs of an individual patient. Technically, the face extends from the bottom of the eyes to below the chin. The brow is not transplanted, as it is part of the skull and has a different blood supply than the lower face. Eyes are not transplanted, either, although eyelids may be part of a face transplant.

"Currently, face transplant can involve soft tissues, nerves, and some of the bony elements from the upper jaw, around the eyes, the mid-face, and the palate," Girotto says. "The facial nerve comes out through that soft tissue and helps you move the muscles, so you must reattach nerve channels to the new tissue. Then the body and the brain must grown new nerve down those tunnels you created. That is the part that takes the longest to heal."

Siemionow notes that outside the U.S., two face transplants have also included the lower jaw.

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