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Face Transplant Sparks Debate

You've probably heard the news about the nation's first face transplant. But here's a quick recap: Yesterday, doctors at the Cleveland Clinic detailed an unprecedented 22-hour operation in which they transplanted about 80 percent of a dead woman's face onto the face of a woman whose face had suffered massive damage. This is only the fourth time anything like this has been tried -- two were done previously in France and one was done in China. But this is the first in North America and by far the most extensive. The recipient essentially had the entire middle of her face -- from the bottom of her eyes to her upper jaw -- rebuilt.

When the first such operation was reported in France in 2005 it triggered massive criticism. People were worried that the recipient, a 38-year-old mother of two named Isabelle Dinoire, had put her life in jeopardy to resolve a problem that might have been terrible, but was definitely not life-threatening. And there were lots of other worries: Would this eventually lead to people getting transplants for purely cosmetic reasons? Or to steal someone's identity (a la the 1997 Nicholas Cage/John Travolta movie "Face/Off")?

But since then lot of critics have come around. Dinoire seems to be doing well, and it turns out that the recipients don't really end up looking like the donors.

That's not to say no one is worried. There are lots of unanswered questions. It remains to be seen how long these transplants will last or what would happen if the body rejects the transplanted tissue. Some say a rejection would be so awful that doctors should be prepared to offer physician-assisted suicide. And it's far from clear how people will adjust psychologically to wearing someone else's face, even if it doesn't look exactly like the person they got it from. Then there's the question about whether people will be less likely to agree to become organ donors if they think their faces might get taken along with their hearts, kidneys and other organs.

What do you think? Care to weigh in on this provocative new development in the world of medicine?

By Rob Stein  |  December 18, 2008; 7:00 AM ET
Categories:  Bioethics , Organ Transplants  
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Medicine has already pioneered other replacement body parts so this is just an extension of that.

But it's very major. I think the receipient needs to have a stable personality. If we as a society expend limited resources financing this for those who've had radically disfiguring problems then they need to hold up their end by taking the immune-suppresants. This is a life-long and rather expensive commitment.

Although the US is pretty liberal compared to other countries about extending big medical procedures to everyone irregardless of age (in the UK no dialysis after 50), I think this seems more appropriate to a younger person who could be expected to live out a long life working and tending to a family.

Posted by: RedBird27 | December 18, 2008 8:19 AM | Report abuse

For critics that are against this surgery, how hard have they fought against breast augmentation implant surgeries, face lifts, etc., since they are not "life threatening"?

Having said that, the harder question will be later choosing who would "get" surgeries such as this and possibly less complex. The choice here would have to be in my opinion, those that can pay for it. Finite resources, e.g., money, drugs and who knows what else won't be able to accommodate everyone.

Posted by: thinkermaybe | December 18, 2008 12:14 PM | Report abuse

Her body, her choice. Period.

Posted by: jerkhoff | December 18, 2008 6:49 PM | Report abuse

At at time of limited resources, who do you think paid for this ridiculous exercise? So many are losing their insurance when they lose their jobs, but the Cleveland Clinic thinks its better to have a whole team of surgeons with their support staff spend 22 hours tying up at least one OR if not several to provide a Guiness book of records surgery. I'm disgusted. I'm sure the recipient, if she hangs on to her new face, will appreciate it, but what a waste of resources!

Posted by: ml2mi | December 18, 2008 8:47 PM | Report abuse

I would worry about the rejection component. If her face rejects they'll need to remove it, potentially leaving her face looking worse than BEFORE the surgery.
I had a double-lung transplant 3 1/2 years ago. I am so glad I did, but you need to be a very stable person to do it. The drug regiment alone is immense, and since skin has the highest rejection rate, this woman will be on very high doses of immuno-suppressants and steroids for the rest of her life. That's a lot of medication with plenty of side effects.

Posted by: choirgirl04 | December 19, 2008 9:47 AM | Report abuse

I guess I'm slow, but I still don't get what the objection is.

All the bioethecists who think this is non-essential should try living with a horribly deformed face.

As long as the recipient is competent to understand what the ramifications are, and stable enough to handle the drug regimen, why shouldn't they have a new chance at a normal dignified life?

They shouldn't be denied this procedure just because someday, some idiot starlet with more money than sanity will choose to spend millions to disfigure themselves.

Posted by: floomby | December 19, 2008 1:28 PM | Report abuse

This is nothing new and has already been done before... The entire medical procedure and subsequent gunfights are available on the Face Off DVD.

Posted by: ozpunk | December 19, 2008 5:11 PM | Report abuse

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