The Psychology of Facial Disfigurement: Implications for Whole Face Transplantation

Abstract

A decade has passed since the publication of the first report from the Royal College of Surgeons in England Working Party on Face Transplantation. Based on evidence available at the time, this report concluded that it was unwise to proceed with whole face transplantation (WFT). Since then, in the region of 20 WFTs have been performed. Data relating to the post-procedural psychological adjustment of a small number of patients are available and further studies have explored the psychological profiles of patients who have undergone other forms of transplantation. Understanding of the specific psychological impacts of WFT remains in its infancy, however, advances in relation to the broader psychology of disfigurement may have relevance in refining the psychological aims of WFT and the care offered to patients. A recently developed framework of psychological adjustment to disfigurement is discussed in relation to protocols for pre-procedural assessment and post-operative support and intervention in WFT.