During the early 90’s, face transplantation was nearly unheard of in the field of plastic surgery. Back then, the only way to remodel a disfigured face was through radical cosmetic procedures, which may have repaired the damaged areas of the face, but still did not give back as much aesthetic appeal as the patient would have liked. But now thanks to the various innovations in the field of science and technology, face transplants are more advanced, making transplant procedures more successful.
A progressive study conducted by the American Society of Plastic Surgeons revealed that even only after a year, facial motor and sensory functions begin to return to face transplant patients. This was presented in the annual medical conference of the ASPS in New Orleans. Not only facial motor and sensory functions were being restored, but the results also suggest that improvements on the speech and social patterns of the patients also gain significant improvement as time passes by.
The head researcher of this project, as well as a member of the ASPS, Dr. Bohdan Pohamac, said that their end goal for these face transplant patients is not just to regain the former aesthetic value of their faces, but also go as far as restoring the normal functions of the anterior skull. He said that in order to achieve this, both the motor and sensory nerves of the facial muscles must be restored to as close as they were before the trauma presented itself. Of course, this was easier said than done, since the nerves that lead to the feeling and function of the facial muscles had totally separate pathways, wherein the primary motor functions of the face is sub served by the Facial Nerve (CN VII) and the primary sensory pathways being covered by the Trigeminal Nerve (CN V). Reconnecting the peripheral nerves present in the muscle to the parent cranial nerves was the main challenge of the plastic surgeons—this, after first reconstructing the physical features of the patient’s face.
There were 4 participants in the study, all of them receiving facial transplants between 2009 and 2011, and their response to motor and sensory stimuli were graded according to partial or significant responses. A few weeks post-operation, it was observed that patients had a very difficult time trying to breathe through their mouths and noses, thus requiring the use of a tracheal tube to assist respiration; also, the patients found it difficult to masticate their food, as well as perform basic facial expressions like smiling or frowning.
A little more than a year after the operation though, the patients began showing large signs of improvement. Patients slowly but surely regained the ability to breathe on their own, without any medical intervention, along with speaking out audible words that their companions could understand. They also learned how to perform basic facial movements and recognize certain odors that were initially undifferentiated during the early part of recovery. Dr. Pomahac said that these are very promising results, and given that these patients had recovered this much within a year, a more significant amount of recovery could then be expected after a longer period of time.