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U.S. Doctors Behind Face Transplants Give Details of Procedure
Date:12/29/2011

By Denise Mann
HealthDay Reporter

WEDNESDAY, Dec. 28 (HealthDay News) -- Full face transplants were once the stuff of science fiction, but not anymore.

So far, 18 such transplants have been done worldwide, and U.S. surgeons describe the intricate procedures in the Dec. 28 online edition of the New England Journal of Medicine.

The article details the stories of three face transplants that were performed at Boston's Brigham & Women's Hospital in 201l, including the much-publicized case of Charla Nash, who lost most of her face in a chimpanzee attack.

While some technical challenges remain, surgeons say they are getting better and better at performing face transplants.

"We don't know how common or rare this operation will be, but it is here to stay," said Dr. Bohdan Pomahac, the director of the plastic surgery transplantation program at Brigham & Women's. He was the lead surgeon on all three cases described in the journal report.

These lengthy and complex surgeries are reserved for individuals with severe facial deformities, but as techniques and technology improve, transplants could become an option for patients with lesser degrees of facial deformity.

Who's a candidate? According to the doctors, prospective recipients first undergo extensive medical and psychological evaluation. If they are deemed to be appropriate candidates, surgeons then begin their search for suitable donors and start to plan the surgery.

Each operation is unique and can take more than 20 hours to complete. In general, surgeons will first remove any non-viable or injured tissue from the face transplant recipient. The healthy tissue, once procured from suitable donor, is then attached. This is not a simple task -- surgeons must restore blood flow, reattach nerves, muscles and bony structures, and then reconnect each layer of the new face.

Even so, "the hardest part is the recovery of the donor face
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