A Better Way to Face Plastic Surgery

Scientists are close to perform the first full-face transplant, but a group of Stanford surgeons hopes to eliminate the need for the complicated surgery altogether by learning to regenerate the skin on the face.

Facial transplants come with many difficulties. The patient must remain on immunosuppressive drugs for life. Sometimes patients have to cope with disturbing feeling of walking around with a dead person's face.

Dr. Geoffrey Gurtner, an associate professor at the Stanford School of Medicine and his team want to use stem cells to regenerate skin. He and his Stanford colleagues have applied for a Darpa grant that would charge recipients with finding ways to treat soldiers injured in battle. Because of improved body armor, more soldiers survive injuries, but many suffer wounds to unprotected areas, typically the face and extremities.

Darpa seeks to develop an integrated package of technologies, some of which could be applied in the first 72 hours after an injury, and others to use during the rest of the rehabilitation phase. Scientists have known for decades that a fetus can heal without scarring, but they still don't know the mechanism behind the process. It's possible that the key lies in low oxygen levels within the womb.

Until scientists figure out regeneration, transplantation will likely be an increasingly common option for patients who have suffered severe facial injuries.

But many plastic surgeons believe the solution to the rejection problem will be in a way to build immuno-tolerance in patients instead of putting them on drugs for the rest of their lives.

Doctors need a permanent solution to immune rejection. The Cleveland Clinic received Food and Drug Administration approval in 2004 to perform a full-face transplant, but surgeons there have yet to perform one. Scientists in the United Kingdom received similar approval from regulatory agencies this week.

Source: AIN