In everyday life, the media and literature, the phrase "second person" bears a pronounced negative load. It is believed that a person should remain himself, regardless of situations and environment, be faithful to himself – to your face, – otherwise there is a danger of acquiring the adjective "hypocritical"; (in other words – «two-faced»).
In aesthetic medicine, concepts are often turned upside down – and what in everyday life seemed bad and unacceptable becomes a real necessity: for example, it happened with face transplant.
Professor, plastic and reconstructive surgeon, specialist in facial anatomy, who was the first in the world to successfully perform Enoc Chambi Venero face transplant.
Why did you decide to perform such a complex operation as a face transplant?
E.Ch.: Face Transplant – The operation is extremely difficult, but in some cases it is simply necessary. Face transplant – last chance for patients whose facial lesions are not amenable to light superficial correction.
When the face is severely deformed, it's not all about beauty for the reconstructive surgeon.
Along with damage to the face, a person is deprived of such simple, but such important opportunities as showing himself to the world, breathing freely and simply eating. Losing the usual outlines of the face, the patient ceases to be himself, because whether we like it or not, our face – this is our business card, what distinguishes us from millions of other people.
So I decided to have a face transplant – an operation that sets the doctor apart from hundreds of others, and gives the patient a second chance to lead a fulfilling life.
Fat transplantation for facial rejuvenation
What psychological impact does a face transplant leave on a patient?
EC: You may be surprised, but speaking of the negative psychological consequences of a face transplant, I can't say almost any. Most often, a person is upset when he sees his reflection in the mirror before the operation.
When a patient has a severely damaged face, he feels alienated: You know that any handicap will significantly isolate us from society, not to mention the inability to breathe even with a damaged nasal septum.
Peculiarities of planning a skin flap transplant operation
After a face transplant, a person will have to get used to it. He adapts to his new "I" with full awareness that once before this very "I" belonged to someone else. It's difficult in places. Along with addiction, a number of other ethical-social issues arise, which, ideally, should be taken care of before the operation.
What difficulties did you encounter in each individual case?
EC: Over the past five years I have been involved in many projects. Fortunately, face transplants are no longer something out of the ordinary.
Compared to the past decades, face transplantation has become almost a routine that is available to anyone if necessary.
It's hard for me to say for sure how many treatments I've had. Regarding the difficulties – they were mainly ethical, connected with the adaptation of the patient with a new face in the society familiar to him, which remembers his former one. Regarding medical and physiological problems, I would note only one: tissue rejection. The patient has to take many different medications to prevent it.
Now we are experimenting with stem cells. In the future, the operation will be carried out, I hope, just as often, and the probability of rejection, if it does not come to naught, will decrease significantly.
Do you use platelet-rich PRP to help your transplanted tissue engraft?
E.C.: Yes, of course, because it's – one of the basic resources that helps to reduce the rehabilitation period of any surgical intervention. You know that platelets are indispensable in the healing process and our body, so the plasma saturated with them makes any aesthetic procedure more effective.
Where to get the skin graft: main donor sites
In addition, any plastic surgeon tries to use all the means available to him to help the patient look his best and make the procedure as painless as possible, as well as reduce and make the rehabilitation period more comfortable.
Tell us about the main features of a face transplant?
E.Ch.: Fundamentals of Facial Transplant Technique – the latest technologies: materials, devices, platforms, devices. Without the scientific and technical process, the procedure would hardly ever become feasible at all. The exact location of tissues, their engraftment, movement measured up to millimeters during the operation – all this is extremely important and is directly related to the result, as well as the state of health of the patient.
Face transplants only became possible in the twenty-first century — this can hardly be attributed to a mere coincidence or the slowness of our fellow predecessors.
What about the nerve endings and vascular network during a face transplant?
E.Ch.: Every plastic surgeon pays maximum attention to the vascular system. The blood supply is of great importance for human health: thanks to the efficient functioning of the vessels, the organs are supplied with nutrients and oxygen. We, medical estheticians, are actively mastering the techniques of microvascular surgery, including a microscope during the operation.
A question that worries patients: the characteristics of the transplanted skin
We do our best to keep the patient's blood vessels safe and sound. I'm sure it's bearing fruit – for example, it reduces the risk of tissue rejection and significantly reduces the healing time after surgery.
Is it true that nerve endings, like nerve cells, do not regenerate?
E.Ch.: Fortunately for the patient, the words about the fact that nerve cells are not restored – nothing more than a common misconception. Yes, several decades ago this myth appeared quite often in the headlines of newspapers, calling to settle down, to shed an extra load of worries, to simply relax – in a word, reduce stress to zero.
In fact, neurons, like other cells in our body, are capable of regeneration. Maybe not as fast as the epithelium, but day after day they still recover – and the sensitivity of the operated areas of the face is slowly but surely returning.
What do you like to see in patients who, thanks to you, have been able to find a new face?
E.Ch.: Most patients who undergo a face transplant look harmonious and whole after the operation. Before transplantation, the defect did not allow them to live fully. They were isolated from society, from being able to do simple but important little things.
After a face transplant, a person is included in life with renewed vigor, he becomes more active, purposeful and cheerful — there is no trace of the former alienation.
It is difficult to quantify, but even with the naked eye you can see how much the quality of a person's life changes.
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