People who have been severely injured or burned, have had head and neck cancer or who have been attacked by animals sometimes lose part or all of the skin and underlying tissues of the face. These traumatic and devastating disfigurements often result in extreme social isolation.
In the past, the only way to repair severe facial disfigurement was with skin, muscle and other tissue grafts – taking pieces of healthy skin from elsewhere on the body or from a cadaver to replace missing parts of the face. But grafts, particularly skin, from other parts of the body don’t look or work like the skin on the face and cannot fully restore appearance or function.
Revolutionary advances in reconstructive surgery and medical technology are making it possible for doctors to transplant part (or all) of a face from a donor. While the transplantation of solid organs has become the standard of care for many life threatening medical conditions, composite tissue allotransplantation (CTA) allows multiple (composite) tissues that may include skin, muscle, bone and nerve, to be transplanted from one person to another – affording a perfect “replacement part” for tissues compromised by birth defects or severely damaged by trauma or disease. CTA has the potential to render better cosmetic and functional outcomes for reconstruction and avoid the multiple extensive surgeries that are currently employed in using the patient’s own tissue.
CTA has been applied to hand and face transplants, abdominal wall, larynx and other tissue transplants. Transplantation offers hope for an improved quality of life to those who suffer from severe disfigurement and is the only surgery with the potential to restore near-normal appearance in patients with socially crippling facial injuries.
Current complicating factors, including the need for immunosuppressive (anti-rejection) medication following CTA, may benefit from developing adult stem cell therapies to induce drug-free tolerance for transplanted organs and tissue.