How is face transplant done

Kihyun Cho, M. Based on that, Dr. Cleveland Clinic surgeons use 3D modeling to help plan for face transplant surgery. Further, ongoing advancements in the specialty areas associated with face transplants are also helping advance the field. In addition to plastic surgeons, the extensive team overseeing the complex procedure includes specialists in anesthesiology, bioethics, dentistry, ophthalmology, endocrinology, infectious disease, psychiatry, pharmacy and transplantation medicine.

While the technical aspects of face transplant surgery are now well-honed by the Cleveland Clinic team, an ongoing concern is one common to all forms of organ transplant: the possibility of rejection. As with any organ transplant, the patients are placed on lifelong immunosuppressive drugs. Such efforts to overcome the hurdle of requiring immune suppression, and the potential side effects of the medications needed to prevent rejection, will be another transformative milestone in the face transplant field.

Are we going to eventually figure out ways to improve tissue tolerance? If we can solve that problem, it opens up a world of good for a lot of patients. Gastman and his colleagues are also hopeful the successful outcomes of the three Cleveland Clinic face transplants, and others throughout the U.

To date, most face transplants have been supported by the U. Gastman exuded. Once the surgical team feels comfortable with you being moved out of the SICU, you will move to a transplant unit, where you will receive care specially designed for all types of transplant patients. You can expect to be in the hospital for about three to four weeks. The amount of time spent in the hospital depends on several things, including the amount of support and assistance you have at home, the distance from your home to the hospital for follow-up care, and any delays that might occur in recovery.

Surgeons and researchers at Johns Hopkins are leading research aimed at warding against rejection and reducing the number of medications patients have to take for the rest of their lives. As with any organ transplant, the greatest risk is that your body will regard your new limb as a foreign object and your immune system will fight against it.

With face transplants, rejection can appear as a rash that could be spotty, patchy or blotchy. It could appear anywhere on the face and is usually painless. As rejection almost always appears first in the skin, patients and their caregivers are encouraged to carefully watch for the signs and report to the physician for timely biopsy and treatment. Unlike internal organ transplants, it is easy to detect and monitor signs of rejection in the face.

This allows for early medical intervention. However, as long as the patient follows the prescribed immunosuppressant regimen, there has been no evidence that the transplant will fail. In a span of just five years, Johns Hopkins Medicine has protocols approved and in place for hand, face and penile transplants—an indication of just how quickly its transplant portfolio has grown, and how the entire field has evolved.

Face transplant patients should be prepared for extensive rehabilitation, which can last from four to six months. Some parts of rehabilitation may be required for life.

The goal for rehabilitation is for the patient to regain function and movement so that he or she can participate confidently in daily activities. Post-surgery assessment and recovery in the hospital usually last for a week or two. Initially, it may be necessary to have breathing supported with a ventilator and feeding done through a tube. Pain medication will be given. After several days of recovery, once sedation is lightened, a physical therapist begins work to restore facial mobility.

Later, a psychologist helps to navigate lifestyle adjustments that come with this type of transplantation. Subsequent physical therapy may involve four to six months of rehabilitation, though the duration and timing of milestones in recovery vary. The immediate goals include promoting both sensory and motor functions of the face.

Not everyone regains the ability to feel a light touch. It is possible for the sense of smell and taste to improve. Over the early months of therapy, additional mechanical skills are developed. These enhance the ability to eat, chew, drink, swallow, talk, blink, smile, and make other facial expressions. Finally, communication skills including facial expressions and speech are refined.

Recovery of motor skills varies greatly between individuals and may be incomplete in many. The immunosuppressant regimen begins soon after surgery. Possible immunosuppressant medications include:. Stem cell treatments may also be used to reduce the immune response to donated tissues. Early indications of an adverse immune response to the donor tissue include painless, spotty, patchy rashes on the face.

Immunosuppressant drugs should be taken as prescribed and must be continued for life. Currently, the only case of rejection has occurred due to going off the immunosuppressive regimen. Depending on the severity of immunosuppression, it may be necessary to wear a mask in public, to avoid social situations that may involve contact with contagious people, and to be cautious of environmental exposure to certain pathogens.

Many of these potential risks can be mitigated by adhering to treatment recommendations, including proper medication use. Physical therapy is integral to making the most of a face transplant. It is a long, intensive process that requires dedication and may benefit from a strong emotional support system. Many individuals who have received a face transplant ultimately find they have better body image, mental health, and ability to socialize.

For those who are presented with the need to undergo a face transplant, a significant traumatic injury or disfiguring disease process has already occurred. It is a procedure that may offer hope to restore a life that may have been lost. Careful consideration prior to the surgery and a commitment to a long recovery course and lifelong immunotherapy is important.

The benefits to those in need, extending from a recovered sense of self to normalized social interactions, cannot be overstated. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Face transplantation—current status and future developments. Transplant International. Johns Hopkins Medicine. Face transplant. Facial and hand allotransplantation. Cold Spring Harbor Perspectives in Medicine.

Functional outcomes of face transplantation. American Journal of Transplantation. Iyer S. Vascularised composite allotransplants: Transplant of upper extremities and face. Indian Journal of Plastic Surgery. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.

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