Facial transplantation: the first 9 years

Abstract

Since the fi rst facial transplantation in 2005, 28 have been done worldwide with encouraging immunological, functional, psychological, and aesthetic outcomes. Unlike solid organ transplantation, which is potentially life-saving, facial transplantation is life-changing. This diff erence has generated ethical concerns about the exposure of otherwise young and healthy individuals to the sequelae of lifelong, high-dose, multidrug immunosuppression. Nevertheless, advances in immunomodulatory and immunosuppressive protocols, microsurgical techniques, and computer-aided surgical planning have enabled broader clinical application of this procedure to patients. Although episodes of acute skin rejection continue to pose a serious threat to face transplant recipients, all cases have been controlled with conventional immunosuppressive regimens, and no cases of chronic rejection have been reported.

Complex facial reconstruction by vascularized composite allotransplantation: The first Belgian case

“…So far, 28 facial allotransplantations have been performed worldwide including our case (14). VCA has become a feasible and reproducible surgical procedure as many technical, logistic, social and immunologic issues have Frontal view of the patient before transplantation after temporary reconstruction with a plicated free ALT flap.…”

Total Face, Eyelids, Ears, Scalp, and Skeletal Subunit Transplant Cadaver Simulation: The Culmination of Aesthetic, Craniofacial, and Microsurgery Principles

“…Patients specifically sustaining electrical, thermal, or chemical soft-tissue injury are prone to dysfunction and disfigurement. To date, over 30 clinical facial vascularized composite allotransplantations have been completed, 10,11 of which at least 16 were total face transplants, 6,10-16 and recently a large portion of scalp was included as part of a facial allograft. 12 Some of the drawbacks to transplanting variable portions of facial tissue include unfavorable aesthetic scar borders, and complications including skin ptosis of multiple facial subunits and adhesions of underlying soft tissue resulting in anatomical displacement, retraction, and dysfunction.…”

Anaplastology in times of facial transplantation: Still a reasonable treatment option?

“…Facial allotransplantation is indicated in adults with massive facial defects and functional deficits which are beyond the scope of conventional reconstruction . Since 2005, more than 28 facial transplants have been performed worldwide, with increasing amounts of tissue transplanted (Khalifian et al, 2014). According to some authors, composite tissue allografts of the face can be considered as the ideal option in the reconstruction of aesthetically pleasing facial units.…”