Facing a surgical identity crisis

The Australian ^ | 19sep05 | AP

[neverdem]

CLEVELAND: Five US men and seven women will secretly visit a medical clinic in Ohio in coming weeks to vie for the chance to have a radical operation that has never been tried anywhere in the world.

They will smile, raise their eyebrows, close their eyes and open their mouths. The Cleveland Clinic's Maria Siemionow will study their cheekbones, lips and noses. She will ask what they hope to gain, and what they most fear. Then she will ask: "Are you afraid you will look like another person?"

Because whoever she chooses will endure the ultimate identity crisis. Dr Siemionow wants to attempt a face transplant.

She is exploring the medical frontier in the hope of giving people disfigured by burns, accidents or other tragedies a chance at a new life. Today's treatments still leave many with scar-tissue masks that do not look or move like natural skin.

These people have already lost the sense of identity that is linked to the face. The transplant is "taking a skin envelope" and slipping their identity inside, Dr Siemionow says.

Her supporters note her experience, planning, the team of experts assembled to help her, and the practice she has done on animals and human cadavers to perfect the technique.

But her critics say the operation is too risky for something that is not a matter of life or death, as organ transplants are. They paint a surreal image of a worst-case scenario: a transplanted face being rejected and sloughing away, leaving the patient worse off than before.

Such qualms recently scuttled face transplant plans in France and Britain.

Ultimately, it comes to this: a hospital, doctor and patient willing to try it.

The first two are now in place. The third is expected shortly.

The "consent form" says the surgery is so new and its risks so unknown that doctors do not think informed consent is possible. Here is what the form tells potential patients:

Your face will be removed and replaced with one donated from a cadaver, matched for tissue type, age, sex and skin colour. Surgery should last eight to 10 hours, and the hospital stay will be 10 to 14 days.

Complications could include infections that turn your new face black and require a second transplant or reconstruction with skin grafts. Drugs to prevent rejection will be needed for life, and they carry the risk of kidney damage and cancer.

After the transplant you might feel remorse, disappointment, grief or guilt toward the donor. The clinic will try to shield your identity, but the media is likely to discover it.

The clinic will cover costs for the first patient; nothing about any others has been decided.

[Ditter]

I saw a program on face transplants on the health network, it was fascinating. The person won't look like they did before the disfigurement but they won't look like the donor either. Their own bone structure will dictate their looks.

[RightWingAtheist]

[RightWingAtheist]