ABSTRACT
The authors have assessed the facial “appearance” of recipient cadavers after mock
facial transplantation, the “appearance” of donor facial flaps following transfer
to artificial head models, and the “appearance” of donor flaps after replantation
back to the same cadavers. Based on the results of different types of facial flap
transplantation, the issue of “identity transfer” is discussed.
Ten fresh human cadavers were dissected. In eight cadavers, the entire facial/scalp
flap was harvested. Two cadavers served as recipients of the donor facial flaps. Two
different types of artificial head models were used as the “recipients” for the harvested
facial flaps. The facial appearance of the recipient cadavers after mock transplantation
was a mixture of features of both the recipient and the donor. The appearance of the
facial flaps mounted on the head models was close to the framework of the head models.
When harvested facial flaps were transferred back to the original cadavers, the facial
appearance was nearly the same as before transplant.
Based on this study, the authors will be able to discuss the variation in post-transplant
appearance with potential candidates for facial transplant. The issue of correlating
facial appearance with “identity transfer” will be difficult to assess until the authors'
first facial transplantation is performed.
KEYWORDS
Face transplantation - identity transfer - composite tissue transplantation
REFERENCES
1
Morris P J, Bradley J A, Doyal L et al..
Facial transplantation: a working party report from the Royal College of Surgeons
of England.
Transplantation.
2004;
77
330-338
2
Siemionow M, Unal S, Agaoglu G, Sari A.
A cadaver study in preparation for facial allograft transplantation in humans: part
I. What are alternative sources for total facial defect coverage?.
Plast Reconstr Surg.
2006;
117
864-872
3
Siemionow M, Agaoglu G, Unal S.
A cadaver study in preparation for facial allograft transplantation in humans: part
II. Mock facial transplantation.
Plast Reconstr Surg.
2006;
117
876-885
4
Rizzo M, Huttig R, Damasio A R.
The role of scanpaths in facial recognition and learning.
Ann Neurol.
1987;
22
41-45
5
Leopold D, Rhodes G, Muller K M, Jeffery L.
The dynamics of visual adaptation to faces.
Proc R Soc B.
2005;
272
897-904
SUGGESTED READINGS
6
Agich G, Siemionow M.
Until they have faces: the ethics of facial allograft transplantation.
J Med Ethics.
2005;
31
707-709
7
Agich G, Siemionow M.
Facing the ethical questions in facial transplantation.
Am J Bioeth.
2004;
4
25-27
discussion W23-W31
8
Banis J C, Barker J H, Cunningham M et al..
Response to selected commentaries on the AJOB target article on the ethics of facial
transplantation research.
Am J Bioeth.
2004;
4
W23-W31
9
Bosch X.
Surgeon denied ethics approval for face transplantation.
Lancet.
2004;
363
871
10 Bull R, Rumsey N. The Social Psychology of Facial Appearance. New York; Springer-Verlag
1988
11
Butler P E, Clarke A, Ashcroft R E.
Face transplantation: when and for whom.
Am J Bioeth.
2004;
4
16-17
12
Caplan A.
Facing ourselves.
Am J Bioeth.
2004;
4
18-20
discussion W23-W31
13 Fridlund A. Human Facial Expression: An Evolutionary View. San Diego, CA; Academic
Press 1994
14
Hettiaratchy S, Butler P E.
Face transplantation-fantasy or the future?.
Lancet.
2002;
360
5-6
15 Powell N, Humphreys B. Proportions of the Aesthetic Face. New York; Thieme-Stratton
1984
16 Russell J, Fernandez-Dols JM The Psychology of Facial Expression. New York; Cambridge
University Press 1997
17
Siemionow M, Agaoglu G.
Allotransplantation of the face: how close are we?.
Clin Plast Surg.
2005;
32
401-409
18
Wiggins O P, Barker J H, Martinez S et al..
On the ethics of facial transplantation research.
Am J Bioeth.
2004;
4
1-12
Maria SiemionowM.D. Ph.D. D.Sc.
Department of Plastic Surgery, A60, The Cleveland Clinic Foundation
9500 Euclid Avenue, Cleveland, OH 44195