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Monday, March 10, 2003Having done trial procedures with cadavers, Butler estimates that the harvesting or ''degloving'' of a face would take approximately two hours, depending on the depth of the excision. It is possible to remove not just skin and subcutaneous fat and muscle but, in the instance of those recipients who have lost some of their skeletal structure, part of the donor's bone and cartilage as well. Still, the deeper the cut, the more complex becomes the reattachment. Once into the sublayers of musculature and bone, there is an increased risk of both rejection and infection, and the problem of having to fuse the donor's facial nerves with those of the recipient, whose face would have already been removed. That, however, does not guarantee the proper synaptic relays between the nerves and could result in what is known as dyskinesia, an internal misfiring of nerve signals that could leave patients twitching uncontrollably or smiling when they mean to frown. For these reasons, Butler is hoping to limit initial attempts to the so-called skin envelope, a subtle bit of sculpturing and resurfacing in and of itself. Once removed from a donor, a face, much like a heart, can survive without adequate blood supply for only a matter of hours before it begins to suffer tissue damage. With the recipient's scar tissue removed and the essential arteries and veins exposed, surgeons would attach them to the corresponding arteries and veins in the harvested face in order to supply both nourishment and drainage. Experiments conducted thus far with animals have shown great success with revascularization of the facial organ. Should a human recipient's subsequent immunosuppression therapy prove successful, they would then face months, even years, of painful healing and physical therapy just to achieve minimal function. But the biggest obstacle may be finding donors: Butler told me of a psychological survey that he conducted of 120 people at his own hospital, one-third of them doctors, one-third nurses and one-third laypeople. The majority answered that they would accept someone else's face if they required one. No one, however, not even his closest colleagues, said they would donate their own. Beauty may only be skin deep, but out attachment to our faces is evidently much deeper. posted by Sydney on 3/10/2003 07:42:00 AM 0 comments 0 Comments: |
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