Alternative Approaches to Face Transplantation: Microsurgical Approach

Abstract

History was made in the USA in December 2008 when news of the ground-breaking face transplant in a 45-year-old woman was performed by Dr. Maria Siemionow and her team at the Cleveland Clinic. With the flurry of public interest engendered by early transplant success, the debate has been framed by the bio-ethics community regarding the autonomy of the recipient (i.e., informed consent), unpredictable effect on those receiving the transplant (life-long immunosuppression and exposure to medical sequelae), and the influence on society as a whole (economic/cost factors). In view of the high stakes of CTA face transplant surgery (not to mention the large amount of visibility in the press), traditional methods of facial restoration should not be overlooked. Considering the significant morbidity inherent to life-long immunosuppression in the transplant patient, each transplant candidate should be carefully evaluated for conservative options utilizing autogenous tissue to address facial deformity in the decision-making process. The following chapter addresses the salient issues regarding the debate between conventional reconstructive options and face transplantation with a particular focus on promulgating the beneficial aspects of traditional reconstruction in select patients.