A short his­tory of face trans­plants

Saskatoon StarPhoenix - - CANADA -

Ef­forts at fa­cial re­con­struc­tion go back to the 1400s, but it wasn’t un­til the emer­gence of both mod­ern medicine and mod­ern war­fare that sig­nif­i­cant ad­vances were made. The Post’s Alexa Tay­lor pro­vides some of the mile­stones of the last cen­tury. 1917

The ma­chine-guns and trenches of the First World War left thou­sands of sol­diers dis­fig­ured. Finely crafted masks made from cop­per, then painted to match pa­tients’ skin tones im­proved their ap­pear­ance to a lim­ited ex­tent. But the Bri­tish doc­tor Harold Gil­lies, now con­sid­ered a pi­o­neer of plas­tic surgery, went much fur­ther — cre­at­ing a sort of flesh mask or rudi­men­tary skin graft. His first suc­cess was Wal­ter Yeo, who suf­fered se­vere burns in com­bat, los­ing both his up­per and lower eye­lids. Skin was taken from his neck and chest and placed over his mid-face, al­low­ing him to blink.


Dr. Archibald McIn­doe, the younger cousin of Dr. Gil­lies, ad­vanced cos­metic surgery by re­fin­ing the way sin­gle slabs of skin, up to the size of an adult palm, were trans­ferred from one part of the body to an­other. This brought dra­matic im­prove­ments in the re­con­struc­tion of eye­lids, lips, cheeks, fore­heads and ears. McIn­doe also ame­lio­rated pa­tients’ hospi­tal ex­pe­ri­ence, serv­ing them beer as they re­cov­ered. Sec­ond World War fighter pi­lots who re­ceived ex­per­i­men­tal treat­ments from McIn­doe formed the fa­mous “Guinea Pig” drink­ing club, which con­tin­ued meet­ing for more than 70 years.


Eleven-year-old Sandeep Kaur was work­ing in a field near her home in In­dia when her hair be­came tan­gled in a grass-cut­ting ma­chine, pulling the flesh from her scalp and face in two jagged pieces. Doc­tors at Chris­tian Med­i­cal Col­lege and Hospi­tal de­cided to forego skin grafts and instead re­con­nect Kaur’s ar­ter­ies and veins with her own skin.


At­tempt­ing to rouse her from an over­dose of sleep­ing pills, Is­abelle Di­noire’s dog gnawed off her nose, chin and lips. To re­store her face, French doc­tors trans­planted a tri­an­gle of tis­sue from a brain-dead donor. The pro­ce­dure made his­tory, but was also highly con­tro­ver­sial. And Di­noire, made more sus­cep­ti­ble to dis­eases by the im­muno­sup­pres­sant drugs she was taking, died of cancer in 2016.


Li Guox­ing re­ceived a par­tial face trans­plant from Chi­nese doc­tors fol­low­ing a bru­tal bear at­tack. But two years af­ter re­ceiv­ing a new cheek, up­per lip, nose and eye­brow from a brain-dead donor, he died af­ter fore­go­ing im­muno­sup­pres­sant drugs.


When Con­nie Culp’s hus­band shot her at close range, doc­tors were tasked with re­con­struct­ing 80 per cent of her face. A team at Ohio’s Cleve­land Clinic re­stored her nose, cheeks, eye and the roof of her mouth us­ing the mus­cles, bones and nerves of an or­gan donor.


A man iden­ti­fied as “Os­car” re­ceived the world’s first full fa­cial trans­plant in Spain af­ter ac­ci­den­tally shoot­ing him­self in the face. Doc­tors in Barcelona gave him new skin, cheek­bones, fa­cial mus­cles, teeth, palate, lips and jaw.


While re­paint­ing the side of a church, the crane Dallas Wiens was stand­ing on col­lided with a high-volt­age power line. Upon re­cov­ery, he was left with a smooth patch of skin travers­ing his face — scant of eyes, lips or a nose. Doc­tors per­formed a full fa­cial trans­plant at Bos­ton’s Brigham and Women’s Hospi­tal, re­con­struct­ing his mus­cles, nerves and miss­ing fea­tures. Wiens re­mains blind, but the surgery re­stored his abil­ity to smell, taste and touch.


In 1997, Richard Lee Nor­ris held a loaded shot­gun to his face dur­ing an ar­gu­ment with his mother. It ac­ci­den­tally went off, maim­ing ev­ery­thing but his eyes. Fif­teen years later, Nor­ris re­ceived a full face trans­plant at the Univer­sity of Mary­land Med­i­cal Cen­ter.


A Pol­ish man iden­ti­fied as Grze­gorz re­ceived a face trans­plant in record time fol­low­ing a work­place ac­ci­dent that left a por­tion of his brain ex­posed to in­fec­tion. Just three weeks af­ter his face was torn off by a stone­cut­ting ma­chine, doc­tors re­stored his nose, up­per jaw and cheeks us­ing do­nated bones and tis­sues.


In 2001, a burn­ing roof col­lapsed on vol­un­teer fire­fighter Pa­trick Hardi­son, char­ring his skin and leav­ing him with­out hair, ears or eye­lids. Hardi­son un­der­went 70 surg­eries and skin grafts but re­mained dis­fig­ured and feared go­ing out in pub­lic. A full face trans­plant dra­mat­i­cally im­proved his ap­pear­ance and his vi­sion.


France’s Jerome Ha­mon suf­fers from a ge­netic con­di­tion that causes dis­fig­ur­ing tu­mours. He un­der­went his first full face trans­plant in 2010. But seven years later, his new face started to die. When an­other donor face be­came avail­able, doc­tors at Paris’ Ge­orges Pom­pi­dou Hospi­tal re­placed the orig­i­nal tis­sues. Ha­mon is a ground­break­ing case be­cause bod­ies that have re­jected an or­gan are gen­er­ally un­able to accept a sec­ond trans­plant.


In a sui­cide at­tempt, then 18-year-old Katie Stub­ble­field blew off her face with a hunt­ing ri­fle. She sur­vived but was left un­rec­og­niz­able. Her si­nuses, mouth, jaw and fa­cial bones were de­stroyed, and her eyes were badly dam­aged. A face trans­plant at Ohio’s Cleve­land Clinic has re­stored Stub­ble­field’s fa­cial struc­ture and func­tions.

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