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BMJ 2005;331:1349-1350 (10 December), doi:10.1136/bmj.331.7529.1349
A new option in reconstruction of severe facial injury
| The first 150 words of the full text of this article appear below. |
The world's first facial transplant has been reported in France (see News p 1359), but whether this signals the opening of a new frontier in reconstructive surgery depends on clinical outcome. Facial transplantation has long been recognised as technically challenging but clinically possible.1 The key area of debate is whether the benefit of this procedure to someone with severe facial deformityin terms of improvement of function, aesthetics, and psychologyoutweighs the risk of long term immunosuppression.
Two years ago the Royal College of Surgeons identified the key issues as patient selection, immunosuppressive risk, informed consent for an untried procedure, and psychological issues (notably altered identity).2 In the two years that have followed the college's report, considerable progress has been made in answering the questions it raised.
Selecting the right patients is paramount. The overall aim of this form of transplant surgery is twofold, as with any facial reconstruction: to
Peter E M Butler, consultant plastic surgeon
(pembutler@gmail.com)
Alex Clarke, consultant psychologist
Department of Plastic Surgery, Royal Free Hospital, London NW3 2QG
Shehan Hettiaratchy, specialist registrar
Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ
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