37 year old man living behind a mask gets a new face

By Dr. Ananya Mandal, MDMar 28 2012

A team of U.S. doctors have carried out what they say is the most extensive face transplant ever performed. The operation at the University of Maryland gave Richard Norris 37, a new face, including jaw, teeth and tongue.

Norris has been living behind a mask for 15 years after being severely injured in a gun accident. He lost his lips and nose in the accident, and only had limited movement of his mouth. The surgery was funded by the US Navy, which hopes the techniques will help casualties from Iraq and Afghanistan.

Surgeons who carried out the 36-hour operation was say it was part of a series of transplant operations lasting 72 hours, using organs from one donor in five patients including Mr. Norris.

The lead surgeon says Mr. Norris will now get his life back. “Our goal is to restore function as well as have aesthetically pleasing results,” said Eduardo Rodriguez. The team at the University of Maryland say Mr. Norris is now brushing his teeth and shaving, and has regained his sense of smell.

“It's a surreal experience to look at him. It's hard not to stare. Before, people used to stare at Richard because he wore a mask and they wanted to see the deformity,” Rodriguez said. “Now, they have another reason to stare at him, and it's really amazing.”

Rodriguez showed a 1993 prom photo of Norris, “as we all want to be remembered,” beside a pre-transplant photo of Norris' shortened face with a sunken mouth and flattened nose. He then revealed a photo of Norris taken on Monday, where his face appears ordinary, other than stitches along his hairline and neck and scarring around his eyelids. Although he now has the donor's face, he doesn't resemble the donor, Rodriguez said. “It's a combination of two individuals, a true blend,” he said.

The US government estimates that 200 wounded troops might be eligible for face transplants. The first face transplant was performed in France in 2005, on a woman who was mauled by her dog. In 2010 surgeons in Spain carried out the world's first full face transplant.

Researchers found that transplants involving large amount of bone marrow with its own blood supply saw fewer or no rejections, transplant surgeon Rolf Barth said. Norris will have to take immunosuppression drugs for the rest of his life to keep his body from rejecting the donated face, but the jaw transplant could mean he will need less and may be able to go off steroids, he said.