Doc­tor in face trans­plant com­ing home

Plas­tic sur­geon trained at Mcgill

Montreal Gazette - - Montreal - AARON DERFEL GAZETTE HEALTH RE­PORTER ader­fel@mon­tre­al­gazette.com

A Mon­treal-born plas­tic sur­geon was part of the team of doc­tors that per­formed the world’s most ex­ten­sive face trans­plant ever in the United States this month.

And Dr. Daniel Bor­suk, who earned his med­i­cal de­gree from Mcgill Univer­sity, is re­turn­ing to Mon­treal in July to prac­tise at two of the city’s hos­pi­tals, per­haps to one day carry out what would be Canada’s first face trans­plant.

“You feel a cer­tain sense of ow­ing back to your com­mu­nity, to the peo­ple who did sup­port you through all those years,” Bor­suk said of his decision to re­turn to Mon­treal.

“I spent 15 years in post­sec­ondary ed­u­ca­tion, mostly funded by the Que­bec gov­ern­ment, at Mcgill and the Univer­sité de Mon­tréal, where I did my res­i­dency train­ing in plas­tic surgery.”

Although he was tempted by of­fers to stay in the U.S., the 34-year-old Bor­suk said, he wanted to be with his fam­ily in Mon­treal. And he couldn’t pass up the op­por­tu­nity to per­form re­con­struc­tive plas­tic surgery on chil­dren with con­gen­i­tal ab­nor­mal­i­ties at Ste. Jus­tine Hospi­tal, and to do the same at Maison­neuve-Rose­mont Hospi­tal for adults se­verely in­jured in ac­ci­dents.

“I think that’s some­thing that I’ll have to dis­cuss with the team in Mon­treal,” Bor­suk said of the pos­si­bil­ity of per­form­ing a face trans­plant in Que­bec. “I think there are a bunch of par­ties that are in­ter­ested.”

Bor­suks’s par­ents are “over the moon” about their son’s med­i­cal ac­com­plish­ments.

“As par­ents, we’re thrilled that he’s com­ing back with his wife and child,” Eileen Bor­suk said. “I think he has a lot to of­fer. It’s a bonus for Mon­treal, Que­bec and Canada to have him share his fan­tas­tic skills.”

On March 19-20, Bor­suk took part in a 36-hour op­er­a­tion to graft a face on Richard Nor­ris, a 37-year-old Virginia na­tive who lost his lips, nose and teeth in a 1997 gun ac­ci­dent. The surgery, led by Dr. Ed­uardo Ro­driguez, took place at the Univer­sity of Mary­land Med­i­cal Cen­ter in Bal­ti­more.

It was the 23rd such face trans­plant in the world, and rep­re­sents a quan­tum leap for­ward in the field, ex­perts say.

“Our case was the most ex­ten­sive done ever, be­cause it in­cluded the up­per jaw, the lower jaw, the teeth, part of the tongue and all of the soft tis­sue from the top of the scalp down to the bot­tom of his neck,” Bor­suk ex­plained.

“We tried to get a more func­tional and es­thetic re­sult by us­ing the en­tire face.”

Nor­ris is re­cov­er­ing bet­ter than doc­tors hoped, as he is al­ready able to move his tongue as well as open and close his eyes.

The surgery was also sig­nif­i­cant be­cause doc­tors ex­pected that Nor­ris’s im­mune sys­tem will tol­er­ate the face trans­plant bet­ter than in pre­vi­ous cases. In Nor­ris’s trans­plant, the in­clu­sion of the jaw – with lots of bone mar­row and a steady sup­ply of blood – of­fers added pro­tec­tion from re­jec­tion.

Bor­suk said that af­ter hav­ing prac­tised in the U.S. for nearly a year, he’s more con­vinced than ever of the mer­its of Canada’s public health-care sys­tem.

“I think it’s fair to say that the av­er­age per­son in Canada gets an ex­cel­lent level of care,” he said. “No mat­ter what sta­tion you are in your life, the av­er­age Cana­dian gets great health care.

“And I think in the United States, the av­er­age per­son gets care that’s be­low that, but if you have the means you’ll get the high­est level of health care and bet­ter ac­cess.

“I ab­so­lutely sup­port a univer­sal health care sys­tem,” he added. “I think it’s para­mount that so­ci­ety take care of its cit­i­zens.”

GETTY IMAGES

Be­fore and af­ter pho­tos show the dif­fer­ence ground­break­ing fa­cial trans­plant surgery made to the ap­pear­ance of Richard Nor­ris of Hillsville, Va. Mon­treal-trained Dr. Daniel Bor­suk was part of the team in the 36-hour surgery.

COOS HAM­BURGER

Daniel Bor­suk is re­turn­ing to Mon­treal this sum­mer to prac­tise at two hos­pi­tals.

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