According to a study in Plastic and Reconstructive Surgery® (PRS), despite the excitement surrounding facial transplantation, the procedure is currently limited to treating severe skin disfigurements. The journal reports that physicians may be a step closer to making the reconstructive process easier for patients with extensive skull and facial deformities.

Plastic surgeons are testing ways to extend facial transplantation to include not only skin and tissue, but bone as well.

The world’s first partial facial transplantation, using facial tissue from another person, was performed in France last year. Maria Siemionow, MD, and colleagues at Cleveland Clinic in the United States, received clearance to perform full facial transplantation using facial tissue from another person, in 2004. The study published in PRS focuses on a procedure in which bone and soft tissues of the face are transplanted. The procedure is in the experimental phase and has not yet received clearance to be performed on humans.

“Victims of serious car accidents, injured soldiers, and patients suffering from cancer and other diseases have to undergo multiple painful reconstructive procedures to recover facial function and still do not regain a pre-injury appearance,” says Siemionow, study author, director of plastic surgery research at Cleveland Clinic. “The ability to transplant facial tissue and skull bone in one procedure advances the treatment of these patients, potentially improving patients’ recovery and allowing them to look, function and feel more normal again.”

In the study, surgeons transplanted both facial tissue and skull bone, in a single procedure, on lab rats. The results of this study will help to establish the anatomical considerations and immunological responses for successfully transplanting facial tissue and skull bone in humans.

By using transplanted facial bone and tissue, which has similar characteristics to the lost tissue, surgeons will be able to create a more natural appearance for the patient and reduce complications from traditional procedures such as skin and bone grafts taken from the patient’s own body. Patients will be required to take anti-rejection medication.

“Further studies are needed, however, based on the results of this experimental study it seems as though this procedure may be a viable option for patients in the future,” says Roxanne Guy, MD, president of the American Society of Plastic Surgeons. “We’re talking about quality of life-enhancing surgery for patients with severe, debilitating facial disfigurements and that’s a good thing. But the benefits and risks have yet to be weighed.”

[www.plasticsurgery.org, December 13, 2006]