Psychological Aspects of Face Transplantation

Abstract

The first face transplantation in France in 2005 started a new era,raising many ethical and psychological issues only speculated aboutbefore this event. Roughly 10% of the US population has some form offacial disfigurement that severely compromises the ability to lead anormal life. Face transplantation appears to decrease depression andverbal abuse that patients experience in public, improve quality of lifeand societal reintegration, though it may not alter anxiety,self-esteem, or sexual functioning. Furthermore, there is a criticalneed for modification of existing rating scales to allow effectiveassessment of face transplant candidates before and aftertransplantation. More systematic data should be collected to furtherexamine whether the long-term physical and psychological outcomes offacial transplantation outweigh the risks of ongoing immunosuppressionin a surgery that is not life saving, but may be life enhancing. Unlikesolid organ transplants which are internal, and therefore``invisible,{''} transplantation of composite tissues, such as the faceand hand, presents a very ``visible{''} difference. Facialtransplantation presents a new challenge for preoperative andpost-transplant care in a vulnerable population.