Burn Victims Have New Hope

When doctors decide to perform the world's second face transplant, burn victims just might be among the first to volunteer.

Burn survivors "love the idea," said Bernhard Heitz, who suffered extensive disfiguring burns to his face and body in a 1997 plane crash and is now president of the World Burn Foundation, a support group.

He said the partial face transplant performed in France last month has given fresh hope to burn survivors who now must endure repeated surgeries using their own body skin to fashion some semblance of a new face.

During the Nov. 27 operation, a 38-year-old Frenchwoman mauled by her dog received a new nose, lips and chin from a brain-dead donor. It was the world's first face transplant and an operation many medical experts consider experimental, but Heitz said many burn victims are undaunted.

Face transplants are not available in the United States, although two medical centers, the Cleveland Clinic and University of Louisville, hope to offer them eventually.

Exactly how many burn survivors might be eligible for such surgery is difficult to say. Some patients might not be psychologically stable enough. And some patients, such as those with severe injuries to the bones, would not be ideal candidates for the operation. The French operation involved a transplant of flesh, and such surgery would do nothing to correct the underlying bone structure.

Sharon Everett, 56, of Cold Spring, Ky., whose eyelids, nose and ears were burned off when pool chemicals exploded in her car five years ago, has been thinking about the transplant case but worries that her body might reject facial tissue from a stranger. The patient in France will have to take potent anti-rejection drugs for life.

Rejection might be less of a risk if the donor were a relative, but Everett said the prospect of taking a loved one's face makes her even more squeamish.

"One of my daughters said if something happened to her, she would want me to have her face. I said, `Oh, Laura, I just could never take your face. ... I just couldn't think of that,"' Everett said.

Amy Acton, executive director of the Phoenix Society burn survivors' support group, said many survivors are intrigued by the French case, but she has not heard about anyone clamoring for an operation. Many are leery of the operation's still-experimental nature and the potential psychological aspects of dealing with a completely new face, Acton said.

Dr. Bruce Cunningham, president of the American Society of Plastic Surgeons, based in Arlington Heights, Ill., said the French case opens up tantalizing possibilities. Such transplants could overcome some of reconstructive surgery's biggest obstacles, such as: "How do you make lips? How do you make a mouth that moves or eyes that open?"

Still, he said his group has not received inquiries from patients wanting a face transplant.

"I think everybody's just waiting to see how this turns out," Cunningham said. He said it could come down to whether the results are better than what doctors can accomplish with reconstructive surgery.

"It's a fascinating thing and if we can move forward with it and get it to work, the applications would be huge," he said.

Heitz, 43, said he gladly would have had a face transplant when he was first injured. Instead, doctors used grafts of skin from his buttocks to rebuild his face, and other grafts for the rest of his body. "I stopped counting at 50 operations," he said.

Phoenix detective Jason Schechterle, who lost his ears, eyelids, eyebrows and all but a stump of nose after his police cruiser erupted in a fireball in a 2001 crash, said he is simply not interested in the procedure.

A few years ago, Schechterle received a questionnaire from a team of U.S. doctors gauging interest in the transplant procedure. Schechterle never bothered completing the survey.

"I wouldn't go through the pain, the recovery and hoping that it worked, all the chances that it wouldn't. What for?" the 33-year-old Schechterle said. "Some people whose appearance is not socially acceptable, they've been deeply affected by that. This, to me, is who I am now. That's my identity."