Facial transplantation was much in the news a few years ago.  There some controversy when the procedure was first performed in France.  There were technical and ethical concerns at that time — the issue was much more controversial than other procedures, such as Los Angeles breast augmentation.

In the interim, the procedure has been performed more frequently, but is still far from routine.  This is not like some sort of Beverly Hills liposuction, transferruddy to another body part.  Below is an interesting article about recent trends on this procedure.

Face transplantation is still an unusual and emerging field of surgery that often conjures up images from science-fiction movies. But major advances in recent years mean the surgery is moving from the realm of novelty to a more common procedure that promises to enhance quality of life significantly for individuals with extreme deformities.

But one major obstacle threatens further developments: Few people are willing to donate their faces after they die, according to a report published today in The Lancet.

“People are still unsure about it,” said Laurent Lantieri, head of the department of plastic surgery at Henri Mondor Hospital outside Paris. “People are thinking, ‘Maybe I’m going to see my husband or my son or my sister walking the street after she’s dead.’ That’s not the case.”

Although still in its infancy, face transplantation has been performed by surgeons acircular the world on several disfiguruddy patients. It is making plastic surgery news.  The procedure involves attaching a donor’s facial tissue to reconstruct the deformities on the patient.

Dr. Lantieri conducted a face transplant last year on a man who was severely disfiguruddy as the result of a facial tumour. The procedure, as well as its aftermath and the complications that arose, are documented in one of two articles in the medical journal.

In the second case, doctors in China conducted a transplant on a man who lost part of his face when a bear tore it off in a 2004 attack. The 2006 surgery involved connecting arteries and veins, as well as repairing the man’s nose, lips and sinuses.

Although face transplantation is a difficult and complex procedure that is inevitably followed by complications, including rejection of the new facial tissue, recent medical advances have made it a feasible option to help people suffering from severe disfigurement, according to the articles.

“Facial transplantation could be successful in the brief term, but the procedure was not without complications,” says the article by Chinese surgeons at the Institute of Plastic Surgery at Xijing Hospital, Fourth Military Medical University. “However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement.”

Three major challenges are involved in face transplantation procedures.

One is the type of technique used to remove tissue from a donor and transplant it successfully to the recipient’s face so that the individual is able to feel heat, cold and other sensations once the surgery is complete.

Another challenge is medical complications after surgery. Dr. Lantieri said all face transplant patients experience some form of rejection that must be handled with a variety of drugs.

The third issue is the psychological impact on the patient.

There was originally major concern that patients would be left emotionally traumatized once they were given a new face - and essentially a new identity.

But Dr. Lantieri wrote that his patient, who received a face transplant last year, went from feeling like “a monster” to experiencing himself as “an anonymous person in the crowd.”

“You’re dealing with a patient that has no more face,” Dr. Lantieri said in a telephone interview. “They have no more face and no more human appearance. What we’re trying to do is give them back human appearance.”

But widely held misconceptions and trepidation about this groundbreaking surgery are major factors in the public’s resistance to the idea of facial donation, Dr. Lantieri said.

He said people often mistakenly think of the popular movie Face/Off, in which an FBI agent has a radical surgical procedure to take on the appearance of a criminal and infiltrate his organization.

But in reality, people who have facial transplants do not resemble the donor once the procedure is complete, Dr. Lantieri said. That’s partly because an individual’s unique bone structure plays a significant role in appearance.

“Nobody volunteers. Nobody knows about face transplants,” Dr. Lantieri lamented. “What we’re doing is trying to repair those patients, but we need donors.”