PSP_facetransplant_webFaces, when transplanted, change their appearance based on the bone structure of the recipient, and may age at an accelerated rate, according to a new study in the American Journal of Transplantation.

Investigators, led by Bohdan Pomahac, MD, director of The Burn Center and Plastic Surgery Transplantation at Brigham and Women’s Hospital and an associate professor at the Harvard Medical School in Boston, followed three full-face transplant recipients for 36 months. Pomahac led the team that performed the first full-face transplant in United States and the third overall in the world. More than 30 face transplants have been performed to date.

The researchers found a significant decrease in facial volume in patients that resembled premature aging, but was driven by a reduction in volume of bone and muscle, not facial fat or skin thickness as is seen with normal facial aging.

The findings suggest the need for effective countermeasures to reverse, delay, or even prevent muscle and bone atrophy to sustain the aesthetic outcomes of face transplants.

Still, “The field of face transplantation is young, and we are all learning about our interventions and their outcomes. We studied why transplanted faces seem to age fast as well as we could, but we don’t really know many other things: When does this process end? Is it possibly a sign of inadequate blood supply or ongoing rejection?” says Pomahac in a news release.