Face Transplants: The Ultimate Makeover?

[Guest guest]

I found this article extremely thought-provoking, and thought I would

share with the groups.

================================

From " NEW YOU SHOW GUIDE " (it was an insert in a magazine I receive,

full of ads & listings for cosmetic procedures in the Toronto, Canada

area).

" An interesting thought about ethics of what is in the forefront of

medicine " . By Mark Bernstein, MD, MHSC, FRCSC

Facial transplantation is an emerging surgical technology that allows

for a donor's face to be removed and succesfully transplanted, along

with its blood vessel and nerve supply onto another person. If your

face were disfigured in a fire, would you want this operation to have

a new face that used to belong to another?

The disturbing image of facial transplantation was popularized for

the public by the movie Face/Off. The medical profession is grappling

with this issue as fiction approaches reality in terms of what we can

do technically. Surgical teams are waiting for permission to treat

the first patient.

What are the medical risks involved? While it is psychologically

challenging and physically uncomfortable for a person to live with a

disfigured face, a face transplant recipient could well have surgical

complications such as poor wound healing. And even in the event that

the surgery goes well with no complications, a patient would require

a lifetime of immuno-suppressive drugs to prevent rejection of the

foreign tissue and these drugs can cause problems. Furthermore, the

psychological harm of having a face that is not the one that you have

up until now identified yourself with must be significant.

The ethics of this require reflection. Even if consent has been given

by the donor, is it not disrepectful of her memory for her likeness

to belong to another woman's person and personality? Furthermore, how

would a woman feel if she saw her dead husband's face on a stranger?

How would the parents of a deceased child ever heal if they saw their

child's face on another boy or girl?

As for the recipient, is it ethical for her to assume a likeness that

belies her true identity? Face transplantation forces us to question

what identity is. Is it what we see, which tends to focus mostly on

the face, or is it someone's beliefs and behaviour? One could argue

that extensive facial plastic surgery that is so common is not very

different from a facial transplant. But one fundamental difference is

that in this case one's face is more than altered - it used to belong

to someone else! And what about where all this could lead? Besides

those disfigured by disease or accident, won't some women simply

dissatisfied with their looks request their plastic surgeons to give

them a new face?

There is no clear-cut answer to whether face transplants should be

performed. Maybe the Utopian world will eventually evolve where inner

beauty truly counts more than outer appearances and we won't have to

answer that. Wouldn't that be wonderful?

Mar Bernstein, MD, MHSC, FRCSC is a neurosurgeon at the Toronto

Western Hospital and Professor of Surgery at the University of

Toronto. He recently completed a Masters in Bioethics. His clinical

interests include brain tumours, lumbar spine surgery, and surgical

philanthropy in the developing world. - for more on this topic, see

the April 22nd 2004 issue of The National Review of Medicine.

[Guest guest]

i saw this on CNN too. pretty crazy what they can do these days. i

think if it offers hope to people who have been disfigured by

horrible accidents, then all the better!

> I found this article extremely thought-provoking, and thought I

would

> share with the groups.

>

>

> ================================

>

> From " NEW YOU SHOW GUIDE " (it was an insert in a magazine I

receive,

> full of ads & listings for cosmetic procedures in the Toronto,

Canada

> area).

>

> " An interesting thought about ethics of what is in the forefront of

> medicine " . By Mark Bernstein, MD, MHSC, FRCSC

>

> Facial transplantation is an emerging surgical technology that

allows

> for a donor's face to be removed and succesfully transplanted,

along

> with its blood vessel and nerve supply onto another person. If your

> face were disfigured in a fire, would you want this operation to

have

> a new face that used to belong to another?

>

> The disturbing image of facial transplantation was popularized for

> the public by the movie Face/Off. The medical profession is

grappling

> with this issue as fiction approaches reality in terms of what we

can

> do technically. Surgical teams are waiting for permission to treat

> the first patient.

>

> What are the medical risks involved? While it is psychologically

> challenging and physically uncomfortable for a person to live with

a

> disfigured face, a face transplant recipient could well have

surgical

> complications such as poor wound healing. And even in the event

that

> the surgery goes well with no complications, a patient would

require

> a lifetime of immuno-suppressive drugs to prevent rejection of the

> foreign tissue and these drugs can cause problems. Furthermore, the

> psychological harm of having a face that is not the one that you

have

> up until now identified yourself with must be significant.

>

> The ethics of this require reflection. Even if consent has been

given

> by the donor, is it not disrepectful of her memory for her likeness

> to belong to another woman's person and personality? Furthermore,

how

> would a woman feel if she saw her dead husband's face on a

stranger?

> How would the parents of a deceased child ever heal if they saw

their

> child's face on another boy or girl?

>

> As for the recipient, is it ethical for her to assume a likeness

that

> belies her true identity? Face transplantation forces us to

question

> what identity is. Is it what we see, which tends to focus mostly on

> the face, or is it someone's beliefs and behaviour? One could argue

> that extensive facial plastic surgery that is so common is not very

> different from a facial transplant. But one fundamental difference

is

> that in this case one's face is more than altered - it used to

belong

> to someone else! And what about where all this could lead? Besides

> those disfigured by disease or accident, won't some women simply

> dissatisfied with their looks request their plastic surgeons to

give

> them a new face?

>

> There is no clear-cut answer to whether face transplants should be

> performed. Maybe the Utopian world will eventually evolve where

inner

> beauty truly counts more than outer appearances and we won't have

to

> answer that. Wouldn't that be wonderful?

>

> Mar Bernstein, MD, MHSC, FRCSC is a neurosurgeon at the Toronto

> Western Hospital and Professor of Surgery at the University of

> Toronto. He recently completed a Masters in Bioethics. His clinical

> interests include brain tumours, lumbar spine surgery, and surgical

> philanthropy in the developing world. - for more on this topic, see

> the April 22nd 2004 issue of The National Review of Medicine.

[Guest guest]

I've seen something about face transplants on TV before, and the whole

program annoyed me because they managed to sensationalize and

trivialize the whole topic at the same time.

Lets see, if you were 'disfigured' would you want a face transplant?

Well probably you'd want your own face back. But thats not gonna

happen. And remember, people who are 'disfigured' tend to have

functional problems, ones that go far beyond vanity and the cruelty of

others. Im sure if you couldnt close your eyes because you lacked

eyelids, or smile because of scar tissue, or chew because of

contractions, I think you dream about having the option of a

transplant.

And stressing the post-transplant psychological trauma of seeing a

face in the mirror that isnt yours isn't enlightening. If you've been

disfigured, the monstrous face staring back at you is ALREADY

traumatizing. It ISNT yours because, duh, you're Disfugured! Its

kind of a moot point. Do you want psychological trauma from a

monstrous face? Or psychological trauma from a normal but

transplanted face? A face transplant would give you that choice.

And would bumping into your donor's family really cause them trauma?

I really dont know. I mean, would you really look like the donor?

Would your different bone structure make you look different? Or would

the doctors be matching you with your donor by similarities in bone

structure in addition to tissue type? Maybe you really would end up

looking alike.

[Guest guest]

Like I said, it's definitely thought provoking. those are some good

questions there!

I've seen something about face transplants on TV before, and the

whole program annoyed me because they managed to sensationalize and

trivialize the whole topic at the same time.

Let's see, if you were 'disfigured' would you want a face

transplant?

Well, probably you'd want your own face back. But that's not gonna

happen. And remember, people who are 'disfigured' tend to have

functional problems, ones that go far beyond vanity and the cruelty

of others. I'm sure if you couldn't close your eyes because you

lacked eyelids, or smile because of scar tissue, or chew because of

contractions, I think you dream about having the option of a

transplant.

And stressing the post-transplant psychological trauma of seeing a

face in the mirror that isn't yours isn't enlightening. If you've

been disfigured, the monstrous face staring back at you is ALREADY

traumatizing. It ISN'T yours because, duh, you're Disfigured! It's

kind of a moot point. Do you want psychological trauma from a

monstrous face? Or psychological trauma from a normal but

transplanted face? A face transplant would give you that choice.

And would bumping into your donor's family really cause them trauma?

I really don't know. I mean, would you really look like the donor?

Would your different bone structure make you look different? Or

would the doctors be matching you with your donor by similarities in

bone structure in addition to tissue type? Maybe you really would

end up looking alike.

[Guest guest]

But would you have the same face as the transplant? I mean, doesn't bone

structure and tissue mass play a part in how your face is ultimately shaped?

Wouldn't it just be a skin donation? I don't know anything about this, but it

seems to me that you wouldn't look exactly like the person who donated the skin.

Re: Face Transplants: The Ultimate

Makeover?

Like I said, it's definitely thought provoking. those are some good

questions there!

I've seen something about face transplants on TV before, and the

whole program annoyed me because they managed to sensationalize and

trivialize the whole topic at the same time.

Let's see, if you were 'disfigured' would you want a face

transplant?

Well, probably you'd want your own face back. But that's not gonna

happen. And remember, people who are 'disfigured' tend to have

functional problems, ones that go far beyond vanity and the cruelty

of others. I'm sure if you couldn't close your eyes because you

lacked eyelids, or smile because of scar tissue, or chew because of

contractions, I think you dream about having the option of a

transplant.

And stressing the post-transplant psychological trauma of seeing a

face in the mirror that isn't yours isn't enlightening. If you've

been disfigured, the monstrous face staring back at you is ALREADY

traumatizing. It ISN'T yours because, duh, you're Disfigured! It's

kind of a moot point. Do you want psychological trauma from a

monstrous face? Or psychological trauma from a normal but

transplanted face? A face transplant would give you that choice.

And would bumping into your donor's family really cause them trauma?

I really don't know. I mean, would you really look like the donor?

Would your different bone structure make you look different? Or

would the doctors be matching you with your donor by similarities in

bone structure in addition to tissue type? Maybe you really would

end up looking alike.

[Guest guest]

I was wondering about that as well. Maybe they are talking about

tissue mass too. But aren't we pretty similar once you get below

that, except for those of us with skeletal issues? Or do those

fractions of a mm really make a big difference?

> I've seen something about face transplants on TV before, and the

> whole program annoyed me because they managed to sensationalize

and

> trivialize the whole topic at the same time.

>

> Let's see, if you were 'disfigured' would you want a face

> transplant?

>

> Well, probably you'd want your own face back. But that's not

gonna

> happen. And remember, people who are 'disfigured' tend to have

> functional problems, ones that go far beyond vanity and the

cruelty

> of others. I'm sure if you couldn't close your eyes because you

> lacked eyelids, or smile because of scar tissue, or chew because

of

> contractions, I think you dream about having the option of a

> transplant.

>

> And stressing the post-transplant psychological trauma of seeing

a

> face in the mirror that isn't yours isn't enlightening. If

you've

> been disfigured, the monstrous face staring back at you is

ALREADY

> traumatizing. It ISN'T yours because, duh, you're Disfigured!

It's

> kind of a moot point. Do you want psychological trauma from a

> monstrous face? Or psychological trauma from a normal but

> transplanted face? A face transplant would give you that choice.

>

> And would bumping into your donor's family really cause them

trauma?

> I really don't know. I mean, would you really look like the

donor?

> Would your different bone structure make you look different? Or

> would the doctors be matching you with your donor by similarities

in

> bone structure in addition to tissue type? Maybe you really

would

> end up looking alike.

>

>

>

[Guest guest]

Consider that forensic pathologists can reconstruct a person's face

with clay from just the skull. There are known measurement points

for every feature based on the skull. Adding a layer of skin on top

just maps to those points. Of course, unique scars, birth marks,

etc, might make the donor a little more easy to identify, but I bet

my skin would look much different on someone else's skull.

Just look at the transformation we all go through when our jaws are

moved, and how we are told we look like a different person, and the

majority of the bone structure stays the same, while the skin is

still the same!

Dammit

> > I've seen something about face transplants on TV before, and

the

> > whole program annoyed me because they managed to sensationalize

> and

> > trivialize the whole topic at the same time.

> >

> > Let's see, if you were 'disfigured' would you want a face

> > transplant?

> >

> > Well, probably you'd want your own face back. But that's not

> gonna

> > happen. And remember, people who are 'disfigured' tend to have

> > functional problems, ones that go far beyond vanity and the

> cruelty

> > of others. I'm sure if you couldn't close your eyes because

you

> > lacked eyelids, or smile because of scar tissue, or chew

because

> of

> > contractions, I think you dream about having the option of a

> > transplant.

> >

> > And stressing the post-transplant psychological trauma of

seeing

> a

> > face in the mirror that isn't yours isn't enlightening. If

> you've

> > been disfigured, the monstrous face staring back at you is

> ALREADY

> > traumatizing. It ISN'T yours because, duh, you're Disfigured!

> It's

> > kind of a moot point. Do you want psychological trauma from a

> > monstrous face? Or psychological trauma from a normal but

> > transplanted face? A face transplant would give you that

choice.

> >

> > And would bumping into your donor's family really cause them

> trauma?

> > I really don't know. I mean, would you really look like the

> donor?

> > Would your different bone structure make you look different?

Or

> > would the doctors be matching you with your donor by

similarities

> in

> > bone structure in addition to tissue type? Maybe you really

> would

> > end up looking alike.

> >

> >

> >

[Guest guest]

Well, I always wonder how close they come to the actual looks of the

person they are trying to reconstruct.

> > > I've seen something about face transplants on TV before, and

> the

> > > whole program annoyed me because they managed to

sensationalize

> > and

> > > trivialize the whole topic at the same time.

> > >

> > > Let's see, if you were 'disfigured' would you want a face

> > > transplant?

> > >

> > > Well, probably you'd want your own face back. But that's not

> > gonna

> > > happen. And remember, people who are 'disfigured' tend to

have

> > > functional problems, ones that go far beyond vanity and the

> > cruelty

> > > of others. I'm sure if you couldn't close your eyes because

> you

> > > lacked eyelids, or smile because of scar tissue, or chew

> because

> > of

> > > contractions, I think you dream about having the option of a

> > > transplant.

> > >

> > > And stressing the post-transplant psychological trauma of

> seeing

> > a

> > > face in the mirror that isn't yours isn't enlightening. If

> > you've

> > > been disfigured, the monstrous face staring back at you is

> > ALREADY

> > > traumatizing. It ISN'T yours because, duh, you're

Disfigured!

> > It's

> > > kind of a moot point. Do you want psychological trauma from

a

> > > monstrous face? Or psychological trauma from a normal but

> > > transplanted face? A face transplant would give you that

> choice.

> > >

> > > And would bumping into your donor's family really cause them

> > trauma?

> > > I really don't know. I mean, would you really look like the

> > donor?

> > > Would your different bone structure make you look different?

> Or

> > > would the doctors be matching you with your donor by

> similarities

> > in

> > > bone structure in addition to tissue type? Maybe you really

> > would

> > > end up looking alike.

> > >

> > >

> > >