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Do you think face transplants are necessary, or cosmetic?

By December 17, 2008 - 9:48am
 
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No one would take issue with a person who needed a heart transplant or a kidney transplant. The surgery is clearly life-saving.

And just a few weeks ago, a 43-year old New York man became the nation's fifth hand transplant recipient. His hand had been crushed and burned in

an accident and had required amputation; he'd been living with a prosthesis for about two and a half years. While he was certainly coping with his prosthesis, would people argue that the desire for an actual hand was vanity? Or that the surgery was cosmetic, or unneccessary?

But the news of the face transplant in Cleveland a couple weeks ago once again has people talking about ethics and whether we are going too far in transplantation. The patient, whose chin and forehead were left intact, received about 80% of the face of another person.

Critics claim that facial transplant surgery is not necessary, because reconstructive surgery can accomplish the rebuilding of a face that has been traumatized in an accident or mauled by an animal (as was the case in the first two face transplants, done in France and China). Surgeons familiar with the cases dissent, saying that there is no tissue on the body that matches facial tissue, and that some patients undergo 30 or 40 reconstructive surgeries hoping to have somewhat of a normal appearance.

From the story:

"Peter A. Clark, director of the Institute of Catholic Bioethics at St. Joseph's University, in Philadelphia, Pennsylvania, said a facial transplant introduces unnecessary risks for a procedure that is not a matter of life and death.

"With something like a liver or kidney transplant, it's a life or death transplant," Clark said. "Even with a kidney or liver [transplant], you have to be put on immunosuppressants with serious side effects."

And from the other side:

"If you look at the outcomes, they're far superior doing a face transplant than any reconstructive surgery," said Dr. David Young, a professor of plastic surgery at the University of California, San Francisco.

"Young said plastic surgeons who do large facial reconstructions often find that patients "never really look that great." "Anyone telling you that doing reconstructive surgery is as good is deluding themselves," he said."

Here's a link to the full story on CNN Health:

http://www.cnn.com/2008/HEALTH/12/17/face.transplant/

What do you think?

Is there a line that should be drawn here? What makes it all right for a donor to give a hand to help another person, but not a face? Are we squeamish simply because the face is so personal, or is there a true worry that this borders on the cosmetic?

Add a Comment2 Comments

If you've never walked among people disfigured by war, disease or natural disaster, it would be difficult to understand how any bodily transplant would affect someone's quality of life.

My grandmother was disfigured by bone cancer that claimed one side of her face. I remember my parents warning me that she would look very different from the way she did before the surgery to remove the affected jaw and other bone. At the time, reconstructive surgery was rather new and "primitive." Once a gorgeous woman with auburn hair, steel blue eyes and engaging smile, she spent the last 20 years of her life hiding behind scarves or not venturing out of the house at all. I can only imagine that, had better procedures been available, she would have opted for more reconstructive surgery so that she would feel more normal, and be able to function more normally (imagine going through life with half a jaw!). Dealing with the physical issues and disease were one thing; dealing with the mental issues were quite another in such a vain society as ours.

Years abroad in war-torn countries, where it's sadly common to see kids disfigured by land mines or other causes, left impressions upon me, as well. I don't fret about crow's feet or bags around my eyes, or about walking out of the house without makeup.

I think the ethical dilemma would come into play for transplantations that would be vanity based. When it's a matter of improving the quality of a patient's life, I don't think it's for any of us to question.

December 17, 2008 - 6:48pm

This does bring up some interesting ethical questions. But, like SusanC, I believe that those of us not having to face this issue (no pun intended) are not in a position to judge whether it's cosmetic or not. It's amazing that there is this option available, and it should be up to the person to choose whether or not they want to undergo such a serious surgery. There are people who don't even blink at having liposuction, and yet there is a risk of infection or even death with that kind of procedure.

December 17, 2008 - 3:42pm
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