Face Transplants And Computerized Surgical Planning Luisa Arias BME 281: Section 2

Face Transplant History  Patients with disfigured faces  Burns  Accidents  Disease  Birth defects  Before face transplants:  Multiple surgeries to transfer skin to face  Patients face could be replanted

Face Transplants  There are two types:  Partial Face Transplant:  First successful one France 2005  Only use part of donor's face for patient  Full Face Transplant  First successful one Spain 2010  Donor's entire face is transplanted onto patient

Richard Norris

Computerized Surgical Planning  Modern way to plan surgeries  High resolution cross-sectional images  3D images can be analyzed on computers  Allows surgeons to perform surgery before actual surgery  Procedure with fewer risks  More time efficient  See how donor’s face fits on patient  See what has to be modified on cranium  3D models used in surgery room

CSP: How It Works  Doctors get a model of patient (CT, MRI, X-Rays, etc.)  Transfer result to computer for 3D model  Includes landmark features to be able to align  Analyze model for usable data  Bones, tissues, blood vessels  Surgery planned and stimulated using 3D model  Model used in operating room as guide

Limitations  Ethical debate on how to deal with donors  In 2011 face transplant cost $353,480  Not always covered by insurance  Surgery lasts 8-36 hours followed by hospital stay  Infections can require second transplant or reconstruction with skin graft  Patient’s immune system compromised  Immunosuppressive drugs for lifetime  $14,000-$20,000 a year

Future  Continue to improve Computer systems  Reduce risk of infection  Find a way to avoid compromising immune system  Figure out how to solve ethical issue

References  Alves, Patrícia V. et al. "Three-Dimensional Computerized Orthognathic Surgical Treatment Planning." Clinics in Plastic Surgery 34.3 (2007): Web  "Computer Assisted Surgery." Wikipedia. Wikimedia Foundation, n.d. Web.  "Face Transplant." Wikipedia. Wikimedia Foundation, 31 Aug Web.  McKenzie, Hamish. "How to Do a Face Transplant." PandoDaily How to Do a Face Transplant Comments. Pandodaily, 1 Apr Web.  Metz, Lionel N., and Shane Burch. "Computer-Assisted Surgical Planning and Image-Guided Surgical Navigation in Refractory Adult Scoliosis Surgery." Spine 33.9 (2008): E Web.  Park, Madison. "The Price Tag for the First Face Transplant in the U.S. Is..." The Chart RSS. CNN, 27 Jan Web.  Soga, S., et al. "CT Angiography for Surgical Planning in Face Transplantation Candidates." American Journal of Neuroradiology (2013): Web