h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Good morning all, I am usually a lurker rather than a poster but thought I would dive in for once and start a conversation.

I just wondered if other posters had any thoughts on the agreement for uk surgeons being given the go ahead for face transplants. The reason for the question is my own thoughts on this matter which I'm trying to understand are strangely at odds with how I expected to feel about it.

Let me explain further if I can articulate my thoughts clearly....

I am in great favour of organ donation, I have registered myself for it, my next of kin are aware of my wishes and in fact I'm inclined more to favour the proposal that we should in fact in the uk, be required to 'opt out' of donation rather than opt in.

Not wishing to get into a religious debate I do not believe I require any of my body for whatever comes after death, indeed I'm undecided as to whether I even believe there is anything after death (another debate) but I'm sure I won't think I need any of my physical being for it.

If I or one of my loved one were unfortunate enough to require such a face transplant I'm absolutely certain that I would be very much in favour of them.

I turly believe that the recipient must (after careful screening for suitable recipients) enjoy a much greater quality of life than before and have watched with interest the case of the French lady.

But to get to the point of my question, given all those proviso's I've given above I can't understand why i feel slightly uneasy about 'my face' actually being given up for donation after my death .............(and whether anyone would actually want it (LOL))

Discussing it with colleagues today others seem to share my strange feelings on this point so I just wondered what other posters thoughts were on this, if indeed anyone has any.........

We have a real personal attachment to our faces. In many ways, our face helps define who we are so it becomes more than just skin, fat & muscle. However, when transplanted I believe it looks totally different due to bone structure etc, so you're not really giving someone *your* face, just components to make a new face.

Having said that, I believe Johnny Depp wants mine when I've finished with it.

Hmm.

I would tend to agree with what you've said on general organ donation.

The fact that we are talking about faces hasn't really caused me much concern up to now but I can see that it could bother the family and friends of a donor, especially if the recipient did then take on the look of the donor. So if I was a 'friends or family' I can see that might be upsetting.

Do we know if that happens? What I mean is, when everything has been connected and put back together, does the recipient look like the deceased donor or just have traits of them, as if they somehow had some of their genes kicking around?

Also, wonder whether safeguards would be in place to prevent the family meeting the recipient, as I believe happens with organ donation - presumably that's impossible as they could just bump into them one day at the shops...

Jules

Simulpost, SWL, hence my question which you've just answered!

Hmm, from what I've read about the operation, most of the problems of someone else walking around with 'your' face on don't actually occur.

As the underlying bone structure and muscular form of the donor and recipient are going to be different, putting your face onto someone elses skull does not produce the same results the same skin covering has on your own head.

Nobody ends up walking around being able to use your old passport.

because, quite simply, our brains learn to identify faces with people and their identities. We know they are unique (although some look very similar there are always slight differences, even in MZ twins) and our brains use this property to essentially short cut the process. Therefore giving our face to someone else 'feels' like giving them your identity.

(there was someone on one of those panel shows with comedians at the weekend I think who said something like 'yeah, and then you could go to the donor's funeral and freak everyone out', which was funny but slightly off the mark since the face will be different due to the differences of underlying structure and stresses on it.

Also, I'm not sure they whether they are talking total face transplants. The French one was about a 1/4 of the face so wouldn;t have the recognition problem.

Following on from SWL's comments, thinking of forensic facial reconstruction, where basically standard thickness muscle/skin layers are applied over a skull, the outcomes seem to depend very much on the skull, and not so much on the skin.

Thinking of how different one individual can look merely by changing hairstyle, makeup, or eye colour via contact lenses, having a 'face' on a different skull, on a different body, with a different hairstyle, and likely different expressions, I doubt a face would have much chance of being recognised even in a line-up, let alone on the street.

That's what I said

<> That's what I said

Yes, but the facial reconstruction analogy maybe emphasises the point to anyone who has seen one of the various forensic TV programs.

A few months ago I read an article about a woman in France who received a face transplant after having been attacked by a dog. The end result was far from a 'perfect face', and certainly not the same face as the donor, as there had been a lot of tissue loss, etc. Apparently she had lost her nose, lips and chin. Anyhow, here is a link to the article.

http://news.bbc.co.uk/2/hi/health/4484728.stm


az

My personal viewpoint is that I don't see it as much different than any other sort of skin transplant. I think the notion of reconstructing a face to look exactly like someone else is the stuff of spy novels and films.

az

I think Icotan may have hit upon the source of my disquiet, that is that my face is what uniquely identifies me - to me!

Whilst I'm aware that its unlikely to look the same when overlayed on someone else's bone and muscle structure it's still the uniqueness of it to me that causes the slight waivering in my usual stance of 'I don't need it so let someone benefit from it'

Some other random bit of tissue whilst just as beneficial to the recipeint is not so unique. However that said on balance I think I would rather agree to donate 'all' the bits of me that are of use including my face to someone who could benefit so much from it than deny someone the chance of a normal (or more normal life) for the want of a donor.

Sam

Most existing transplants are an internal matter, so nothing to see to indicate origin. Would we feel the same disquiet about a skin transplant elsewhere on the body? Probably not, if not visible.
Do you recall the experiments doing a whole hand transplant? I think that would be far more identifiable (& obvious) than a face. If they stuck to calling it skin transplant, I'm sure there'd be less unease.

Perhaps the other unease factor is picturing the corpse. At present, the body could be viewed after removal of relevant bits & you'd be none the wiser. Not so with the face.
I too, am registered as a donor & am happy to include my face, but I can imagine feeling less than happy at the prospect of one of my loved ones being so mutilated after death.

I saw the Horizon feature on the French lady. Although the sight of her without her surgical mask was not as frightful as one might imagine, she was an obvious candidate for such a technique. The result was a great improvement for her.

What the surgeons did point out, which would be a major factor in selecting patients, is that the recipient's face has to be prepared i.e. possibly removing more skin. In the event of transplant failure, they could be left with a worse disfigurement than before.

I think, taking the identity bit further, that this does extend to other transplants but depends on the personal value one puts on the bit being replaced.

I seem to recall that one of the early hand/arm transplants had a bit of thing about it as they had used a donor arm that was of a different skin colour to the recipient. Can't remember whether the recipient rejected it or not. But again, something like skin colour can be a personal identifier.

One that was rejected was the Chinese first recently of a penis transplant. The surgery was a success but later the man and his wife asked doctors to undo the operation due to 'severe psychological problems'. And a penis is usually very private and personal.

It's interesting cos it then starts going into the psychology of identity, which many theories state as a social phenomenon, whereas the reactions to this seem to reflect an internal, personally built identity.

The hand in the case I saw was very different. It was eventually removed because the recipient didn't like taking the immunosuppressants & rejection set in.

We should of course consider the recipient having to accustom themselves to a new appearance. It's akin to counselling someone before plastic surgery. If the patient cannot accustom themselves to less than perfection, they may be disappointed with a transplant. On the other hand, it might improve the quality of their lives immensely.

"On the other hand"
Very good

It's kind of a creepy idea, but I think that it's also a good idea, if you're willing to donate.

After seeing a friend (who was once a decent-looking person) reduced to a skull after a fire and the emotional damage that that has done, I can only imagine what a dream it would be to be able to go out in public again looking relatively normal without a ski mask or scarf.

Very cool.

Morning Samsonite600

For a 'dive in' post it is a good one.

I too am a registered donor, though at my age I'm not sure which 'bits' might be useful.

On a practical level, Radio 4 ran a interview with transplant specialists yesterday afternoon, which confirms other poster's comments that 'your' face - if used - would deform to 'fit' the substrate over which it was fitted. A bit like shrink wrapping I suppose in that the same film can cover a spanner or a screwdriver!

If the procedure succeeds, and if people who currently have to endure disfigurement can be helped , then hopefully it would be valuable in restoring their lives and as such should be commended.


On a purely personal note, I cannot see anyone actually wanting mine...

Novo