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Wow, a second US face transplant was completed at Brigham and Women’s Hospital last week.  This is a true improvement in the way plastic surgeons reconstruct patients suffering massive, deforming facial injuries.  In this particular case, most of the mouth was restored.  The surgery will go a long way in allowing the recipient to eat and drink again.  In addition, the physical appearance will be better than the results of any of the other reconstructive techniques we have available.

Transplant surgery is no stranger to plastic surgeons.  Skin, bone and cartilage are use by all plastic surgeons in reconstructive and cosmetic surgery.  Of course, this is usually comes from a patent’s own tissue.  When the first kidney transplant was done in 1954, the transplant surgeon was Dr. Joseph E. Murray, a plastic surgeon. The donor was the recipient’s identical twin brother.  Dr. Murray received a Nobel Prize for this surgery in 1990.

With the advent of greater understanding of transplant drugs and transplant rejection, transplant surgery has come full circle back to plastic surgeons.  Before this time it was felt that external transplanted donor tissue would heal poorly, if at all.  It was also feared that external injury would not be tolerated in the face, resulting in possible graft rejection.  Plastic surgeons are once again on the cutting edge of transplant surgery.

We are a long way form the movie Face/Off.  External donor transplants for hands and face are still in their infancy, but making great strides.  The risks of anti- rejection drugs can only be justified when significant functional improvement can be shown.  It will be decades until these new techniques can be applied to elective cosmetic surgery.

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