Abstract
The aim of this study was to describe two methods of face-harvesting techniques -- a skin and soft tissue flap and a combined osteocutaneous flap -- and to demonstrate the compatibility between donor and recipient in a human fresh cadaver model. In fresh human cadavers the skin and soft tissue of the face (type 1) and a combined osteocutaneous flap (including a le Fort III segment, type 2) were harvested. The faces were subsequently exchanged among the donor crania, simulating full-face transplantation. Both flaps are based on the external blood supply of the faciotemporal vessels and the external jugular vein. The end branches of the trigeminal nerve could potentially be used for restoration of sensation (type 1 flap). With type 2 flaps the facial expression may be restored with the inclusion of the facial nerve. Four morphological parameters determine the donor/recipient compatibility: skin color and texture, anthropometric head dimensions, specific soft tissue components (nose, lip, cheek, and eyebrow), and gender. Apart from ethical considerations, long-term immunosuppression will remain the limiting factor of full facial transplantation in the near future.
References
Aug 1, 1970·The Laryngoscope·P Kluyskens, S Ringoir
Jan 1, 1993·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery· Levashov YuNI M Kuznetzov
Dec 29, 1998·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D ErdmannG Lemperle
Jan 11, 2001·Microsurgery·G O Hofmann, M H Kirschner
Jun 5, 2002·Plastic and Reconstructive Surgery·Hanns P SchierleDetlev Erdmann
Feb 28, 2004·Expert Reviews in Molecular Medicine·A Bushell, K J Wood
Apr 28, 2004·Transplantation Proceedings·M LanzettaH Kapila
Jul 15, 2004·Transplantation Proceedings·G SelvaggiA G Tzakis
Dec 4, 2004·Plastic and Reconstructive Surgery·Yavuz DemirMaria Siemionow
Sep 30, 2005·The American Journal of Bioethics : AJOB·Osborne P WigginsJoseph C Banis
Mar 10, 2006·Plastic and Reconstructive Surgery·Maria SiemionowSakir Unal
Mar 15, 2006·Annals of the New York Academy of Sciences·Richard A Steinhardt
May 3, 2006·Plastic and Reconstructive Surgery·Rod J RohrichBruce Cunningham
Jul 18, 2006·Lancet·Bernard DevauchelleJean-Michel Dubernard
Aug 15, 2006·Lancet·Peter E M ButlerAlex Clarke
Oct 5, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Brian GanderJohn H Barker
Oct 25, 2006·Annals of Plastic Surgery·Alessio BaccaraniL Scott Levin
Nov 2, 2006·Annual Review of Medicine·Geoffrey C GurtnerMichael T Longaker
Jan 16, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Aidan Martin Fitzgerald
Jan 27, 2007·Plastic and Reconstructive Surgery·Alessio BaccaraniDetlev Erdmann
Feb 1, 2007·Transplantation·Peter MorrisNichola Rumsey
Mar 24, 2007·Aesthetic Plastic Surgery·Nestor Torio-PadronJoerg Borges
Jan 8, 2008·Clinical and Experimental Dermatology·S Avninder, V Ramesh