Surgeon To Try Face Transplants

To Be Offered To Disfigured Patients

(AP) 
The clinic will cover costs for the first patient; nothing about others has been decided.

Another form tells donor families that the person receiving the face will not resemble their dead loved one. The recipient should look similar to how he or she did before the injury because the new skin goes on existing bones and muscles, which give a face its shape.

All of the little things that make up facial expression — mannerisms like winking when telling a joke or blushing at a compliment — are hard-wired into the brain and personality, not embedded in the skin.

Some research suggests the end result would be a combination of the two appearances.

Surgeons wished they could have done a transplant six years ago, when a 2-year-old boy attacked by a pit bull dog was brought to the University of Texas in Dallas where Dr. Karol Gutowski was training.

The boy received five skin grafts in a bloody, 28-hour surgery. Muscles from his thigh were moved to around his mouth. Part of his abdomen became the lower part of his face. Two forearm sections became lips and mouth.

"He'll never be normal," said Gutowski, now a surgeon at the University of Wisconsin-Madison.

Surviving such wounds can be "life by 1,000 cuts." Patients endure dozens of operations to graft skin inch by inch from their backs, arms, buttocks and legs.

A face transplant could be a better solution.

Despite its shock factor, it involves routine microsurgery. One or two pairs of veins and arteries on either side of the face would be connected from the donor tissue to the recipient. About 20 nerve endings would be stitched together to try to restore sensation and movement. Tiny sutures would anchor the new tissue to the recipient's scalp and neck, and areas around the eyes, nose and mouth.

"For 10 years now, it could have been done," said Dr. John Barker, director of plastic surgery research at the University of Louisville. Several years ago, these doctors announced their intent to do face transplants, but no hospital has yet agreed.

However, Siemionow had been experimenting on animals. She got clinic approval to try the operation on people and insists she is not competing to do the first case.

"I hope nobody will be frivolous or do things just for fame. We are almost over-cautious," she said.