Facial Reconstruction: A Glimpse Of The Future

On Thursday the 7th of May, Saving Faces in association with The BioCentre presented an afternoon and evening event hosted by the Dana Centre as part of its Summer Events Programme. Both events were free; the afternoon section (Saving Face) was for interested professionals/organisations and concerned the implications for facial surgery of new technology and techniques. The evening event (Facing Up) was open to everybody and explored the same issues in more general terms.

The more informal evening meeting included presentations from and discussions between surgical, scientific, psychiatric and ethical colleagues. As a direct result of this meeting a team of British surgeons and scientists are collaborating to carry out facial reconstruction using the patient’s own stem cells to generate new tissue. The team is led by Professor Iain Hutchison, who organised the conference.

Facial deficits causing disfigurement can involve loss of bone, muscle fat and skin. In the past 3 decades surgeons have found revolutionary ways to reconstruct the face using huge segments of tissue from the patients’ own bodies but this necessitates 2 long operations, one to harvest the tissue from one part of the body and the second to fashion it to approximately the correct shape of the facial defect. This also can cause problems at the patient’s donor site and usually does not reproduce facial form and function exactly.

The recent use of facial transplants from dying donors has gone some way to solve these issues but has created new problems. The patient has to take immunosuppressant drugs for the rest of their lives and these drugs increase the risk of infection and cancer and generally weaken muscles and bones. These problems are highlighted by the young Chinese man who received the world’s 3rd face transplant and who stopped taking the drugs, lost the transplant and died.

Professor Iain Hutchison and his colleagues believe that tissue engineering is likely to provide the best solution to the challenges of facial reconstruction. With the active participation of their patients, the British team plan to build replacement facial and skull bones in the patients’ own bodies using the patients’ own stem cells, genetically engineered proteins which stimulate correct growth and computer generated scaffolds.