Latest Face Transplant Surgeries Restore Form and Function

By Jeffrey Soares, USAMRMC Public Affairs

At the 2012 Medical Health System Research Symposium in Fort Lauderdale, Fla., high-tech programs and products are being discussed by researchers focused on translating futuristic technology into modern-day practice.

In the 1990 sci-fi film “Total Recall,” Arnold Schwarzenegger’s character receives a new face via high-tech methods, so that he can elude pursuers.  The image causes viewers to imagine a world where this is not only possible, but typical.  Today, providing a new face to someone in need is on its way to becoming typical thanks to the work of researchers such as Dr. Eduardo Rodriquez, who is the chief plastic surgeon at the R Adams Cowley Shock Trauma Center at the University of Maryland.

In his Aug. 14 presentation, “Comprehensive Facial Transplantation,” Rodriquez conveyed how he and his surgical team at Maryland used every resource available during a 36-hour surgery to attach a healthy donor face to a 37-year-old gunshot victim whose own face was disfigured.  The procedure is considered to be the most extensive operation of its kind ever performed.

Although the patient, Richard Lee Norris, is a civilian from rural Virginia, Rodriquez described the implications for warfighters.

“The ultimate goal of this project was to treat the wounded warrior,” Rodriquez said.  “We wanted to develop a strategy that would essentially reconstruct the massive disfigurement of the face of soldiers [wounded in battle].”  He added that beyond appearance the goal is to restore function.

“As injuries between the lower face and upper face are considered very difficult injuries to treat, the operation to repair these injuries must be proportionate to the problem in order to take these patients to the next level,” Rodriquez explained.

Rodriquez and his team -- specialists in craniofacial surgery and microsurgery -- spent hundreds of hours in rigorous training and rehearsal before the patient ever entered the operating room.  In a procedure of this magnitude, no margin of error could be tolerated by the surgical team.  They studied the underlying relevant clinical anatomy to ensure proper transplantation, and they also considered the procedure from an aesthetic perspective, to see where incisions could be placed in order to go undetected.

The team used computerized surgical planning to ensure the exact transfer of the donor face to the patient, and they were extremely thorough in aligning the oral/dental/tongue configuration during the transfer to ensure that the patient could chew and speak correctly.

Considering the magnitude of this procedure, it is nothing short of amazing that the patient is recovering on schedule at this time.  Upon showing a comparison photo of Norris prior to and following the extensive surgery, Rodriquez himself appeared a bit surprised -- and pleased -- about the recovery.

“You can appreciate the dramatic change in this individual’s not only appearance but also function,” Rodriquez said.  “This would not have been possible with conventional measures.”

The doctor and his team plan to continue performing state-of-the-art craniofacial reconstructions, with a goal of 3-5 facial transplantation surgeries per year.