MattKennard.com

The surgeon who conducted the worlds first face transplant described his breakthrough at a prestigious memorial lecture at New York University last night.

Professor Bernard Devauchelle gave the 44^th V.H. Kazanjian Memorial Lecture to a packed audience at the Institute of Reconstructive Plastic Surgery.

The lecture hall was filled to the rafters with students and medical staff, many standing in the aisles because of overcrowding.

The first transplant operation was performed on 27^th November 2005 when Professor Devauchelle and his colleagues had taken the central and lower face of a brain-dead woman and grafted it onto a woman who’s face and nose had been mutilated by a dog.

“There are many problems and worries,” he said, speaking in English but with a thick French accent. “Most importantly is the fear of rejection by the recipient.”

It was a 15-hour long effort which involved intricate surgical work on nerve and muscle in the face and a harvest from the forearm of the patient. “The problem is it is impossible to live without sensitivity so we had to get it right,” he said.

At the end of the surgery his team had decamped to another city, Amiens, to give the patient a bone marrow infusion. “It was raining and horrible that night!” Devauchelle said, to laughter from the crowd.

Before this revolutionary transplant, the convention had been to surgically ‘touch-up’ badly disfigured faces. “We have to develop our methods even more,” said Devauchelle. “But if you compare the results of surgical action with that of a transplant there is just no contest, transplant wins every time.”

Devauchelle put up pictures of the patient over the two years after the operation.

“As you can see,” he said, “in November 2006, just a year after the operation, the face is nearly perfect.”

Throughout the lecture pictures of disfigured, burnt and skinless faces were shown up on the screen, some of which were greeted with gasps from the audience.

Towards the end of his lecture, Devauchelle explored the ethical and moral dimensions of his work. He talked at length about the philosophical and psychological effect on the patient. “The patient was very enthusiastic before the operation,” he said, “but could she really say “It’s me” after she had a different face? What is identity?” he continued. “It is to 1. recognise ourselves; 2. To belong to a society; 3. To be recognised as a unique individual in the judicial system… We must try to maintain all of these in a patient.”

He continued with the criticism his work had garnered from other academics. “The first criticism is always: Is disfigurement serious enough to warrant massive plastic surgery and costs? The second is: The patient attempted suicide. The third is: Living with the face of death is not possible,” he said.

Professor Devauchelle finished with the prospects for the future in this burgeoning field. He told of the Chinese follow-ups and showed a video of surgeons there performing a similar operation. The creation of a European Network called Centaure is also underway, he said, with the French government agreeing to perform five new face transplants in the 2007-2012 period.

There was no question and answer session, but the Dean of the Institute said: “This has truly been a memorable evening. We all admire you as a physician, but also as a human being.”

Charlotte Spinner, a 3^rd year medical student at NYU, said: “I thought it was very educational, I’m inspired to go into something like this now. He showed how you can really transform peoples lives through cosmetic surgery which is something I had never really thought about before.

Evann Eisenberg, 22, a 1^st year medical student at NYU, said: “He was so passionate about his work, it was amazing. I want to be able to do something like that when I get into the real world of medicine. I’m not particularly interested in plastic surgery but that passion definitely inspired me.”

This post is tagged