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Face transplants: Real life science fiction

By Teresa Branch-Smith Eight years after Nicolas Cage changed his identity with a face transplant in the 1997 movie Face Off, life began to imitate art.
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Richard Norris was given a new lease on life after undergoing a complete transplant of his face. Photo University of Maryland Medical Center. Supplied photos.

By Teresa Branch-Smith

Eight years after Nicolas Cage changed his identity with a face transplant in the 1997 movie Face Off, life began to imitate art. The results are truly remarkable — perhaps as remarkable in real life as they were in science fiction.

In March of this year, 37-year-old Richard Norris received a completely new face, including jaws, teeth, tongue, muscles, and skin from his scalp to his neck. It took a day and a half of surgery at a hospital in Baltimore, Maryland.

Fifteen years ago, ironically in the same year as Face Off began making millions in movie theatres, Norris was the victim of a devastating gunshot wound to his face.

Months after the surgery, doctors say he has regained control of most of his facial expressions and can even eat and move his tongue. It wasn’t just his skin and muscles that were replaced, but nerves as well.

Norris is even reported to be playing golf and mingling with people after living as a recluse for15 years, hiding his ravaged face behind a mask.

Photographs and video of the remarkable operation are available at the University of Maryland Medical Centre website (umm.edu). Viewing them might seem a bit ghoulish or voyeuristic, but, considering the life this man had prior to the surgery, they are extraordinary and much closer to inspiring.

Perhaps with medical technology constantly pushing the bounds of possibility, it was just a matter of time before face transplants became an actual surgical practice and not just science fiction.

However, they are, not surprisingly, still rare. Few places have the huge teams of surgeons and specialists of up to 100 that are required to perform it. The cost is also an obvious factor — it costs about $1 million for the people, time, technical expertise and resources to pull it off.

There are several projects underway to establish centres across the globe able to perform these seemingly miraculous surgical feats.

The first partial face transplant occurred in France in 2005, while the first full face transplant was conducted in Spain five years later. As of July 2012, only 24 face transplants had been done in the entire world, none of them in Canada.

There is currently interest in establishing the first Canadian face transplant facility in Halifax.

Prior to transferring entire faces, surgeons would utilize patches of skin from other areas of the body like the back, to repair damaged facial tissue. This was limiting because it gave a quilt like appearance due to scarring and discolouration.

As with any type of transplant, the hardest part remains being able to reconnect the nerves allowing the recipient to feel their new skin, and to smell and taste. Combating tissue rejection with immune-suppressant drugs is another major challenge.

None of these amazing operations would have been possible without the heroic decisions of organ donors and their families. Organ donation of any kind is an effective and wonderful way of helping others. Healthy skin, organs like hearts, kidneys and lungs, eyes and, yes, now even faces can be the ‘ultimate gift’.

And it isn’t so long since those transplants were in the realm of science fiction.

Many people are thankful life has begun to imitate art and we all have the organs that can help it happen.

Teresa Branch-Smith is a student in the Laurentian University/Science North graduate program in Science Communication. Have a burning science question that can be answered in Northern Life's new science column, Talking Science? Send your question to [email protected].


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