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Face transplants like Charla Nash's: A growing list of successes

August 12, 2011|By Daniela Hernandez, Los Angeles Times / For the Booster Shots blog
  • Charla Nash received a face transplant in June. The left image is of Nash before her injury; the right shows her after her face transplant.
Charla Nash received a face transplant in June. The left image is of Nash… (Reuters )

Charla Nash — the Connecticut woman who was mauled by her friend’s pet chimpanzee in  2009 — revealed her new face on NBC’s "Today" show on Thursday.

She  lost her hands, lips, nose and eyes in the attack, along with her ability to see, smell and a speak clearly. The surgery did not restore her sight.

Nash is not the first person in the world —or even in the U.S. — to receive a face transplant. More than a dozen of the procedures have been performed in France, Spain, China and the U.S.

Here are some milestones regarding the procedure, which is still considered experimental:

- The world’s first partial face transplant was performed in 2005 on Isabelle Dinoire of France after her dog  chewed off her lips, chin and part of her nose. She had taken sleeping pills before the incident.

- The first face transplant in the U.S. (and the fourth worldwide) was performed in 2008 in a 22-hour operation at the Cleveland Clinic. Connie Culp of Ohio, who lost the middle of her face after her husband shot her in 2004, was the recipient. Her transplant was considered the most complex ever performed at the time.

- Doctors in Spain performed the world’s first full face transplant in 2010 on a farmer who had accidentally shot himself in the face in 2005.

- Dallas Wiens, a construction worker from Texas, became America’s first full-face transplant recipient in March, two years after his face was burned off when the cherry picker he was riding touched a power line while he was painting a church. Weins lost his nose, lips, eyebrows and vision in the accident.

This is how the procedure works:

As with any other transplant, doctors must first find potential donors. They screen the donor’s and recipient’s so-called MHC  proteins: If these are not well matched, it would trigger the immune system to attack foreign invaders –in this case, the donor’s face.

- Once a match is found, surgeons cut and peel  away  the donor’s face and its underlying structure — the skin, muscles, fat, nerves, blood vessels, bones and teeth, according to the Cleveland Clinic. How much of the donor’s face is used depends on the severity of the recipient’s injuries.

- The donor face is packed on ice to prevent damage and transported to the hospital where the recipient is waiting.

- Surgeons prep the recipient by removing any damaged tissue that remains. Then they use tiny needles to sew together nerves, muscles and blood vessels. Finally, they position the new face over the patient’s skull to sew it in place.

- After surgery, patients are monitored closely and have to take immunosuppressants indefinitely to make sure that their immune systems don’t reject their new faces.

Doctors warn recipients that it will take time to regain feeling in their faces and that there may be psychological effects because they won’t look the same way they did before the surgery.  But patients won’t  look exactly like their donors either.

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