- Surgeons from the University of Maryland Medical Center on Tuesday detailed what they said was the world’s most comprehensive face transplant - allowing a 37-year-old man to emerge from behind a mask 15 years after a gun accident almost killed him.
Richard Norris of Hillsville, Virginia, was shot in the face in 1997 and lost his nose, lips and most movement in his mouth. Since then, he has had multiple life-saving and reconstructive surgeries but none could repair him to the extent where he felt he could return to society. He wore a prosthetic nose and a mask even when entering the hospital for the transplant.
But last week, during a 36-hour operation, University of Maryland doctors gave him a new face from an anonymous donor whose organs saved five other patients’ lives on the same day.
Six days after the surgery, he could already move his tongue and open and close his eyes and was recovering much faster than doctors expected.
“He’s actually looking in the mirror shaving and brushing his teeth, which we never even expected,” said Dr. Eduardo Rodriguez, associate professor of surgery at the University of Maryland School of Medicine and head of the transplant team, who spoke at a press conference.
When Norris opened his eyes on the third day after the surgery with his family around him, he wanted to see a mirror.
“He put the mirror down and thanked me and hugged me,” Rodriguez said.
“I think it’s extraordinary,” said Dr. Seth Thaller, professor and chief of plastic surgery at the University of Miami Miller School of Medicine, who was not involved in Norris’ surgery. Twenty-two face transplants have been performed previously worldwide, but most of these involved only soft tissue and not teeth and bone, Thaller said.
“Basically they’ve restored the entire facial function and form,” he said.
There have been concerns in the past about the psychological consequences of receiving a new face. Before the surgery, Norris underwent rigorous psychological testing to ensure he was a good candidate for the surgery, his surgeons said.
The operation follows successful face transplants in Forth Worth, Texas, and Boston, Massachusetts, last year and it seems to be the most aesthetically successful to date, according to photographs and video shared with reporters at a news conference.
Norris, who is still recovering in the hospital and did not appear at the media event, is the first full face transplant recipient in the United States to retain his eyesight.
“We concealed all the lines so it would give him the most immediate best appearance with minimal touch-ups down the road,” Rodriguez said later in an interview.
To ensure Norris would retain maximum function of his facial expressions and movements, doctors gave him a new tongue for proper speech, eating and chewing, normally aligned teeth, and connected his nerves to allow for smiling.
The transplant was “an amazing feat,” said the dean of the School of Medicine, Dr. E. Albert Reece at the press conference.
“It’s also an unprecedented and historic procedure that we believe will change, if you will, the face of medicine now and in the future,” Reece said.
Rodriguez said the donor also donated several other organs, saving the lives of many people.
This is the 23rd face transplant performed around the world. Several face transplants have been performed in the U.S., including three full-face transplants at Brigham and Women’s Hospital in Boston.
Those transplants, which were performed on Dallas Wiens and Charla Nash, were detailed in a 2011 issue of New England Journal of Medicine.
About 100 doctors, scientists and other university medical staff ranging from plastic surgeons to craniofacial specialists teamed up for the operation.
The surgery involved 10 years of research funded by the Department of Defense’s Office of Naval Research and will serve as a model for helping war veterans injured by improvised explosive devices in Afghanistan, the university said.
Rodriguez saluted the work of the teams around the world that had conducted the 22 face transplants to date, without which, he said, this operation would not have been possible.
by Hamish McKenzie