Could You Love Someone Without a Face? Making Facial Transplants Common Practice

With just 25 cases on the books worldwide, leading surgeons push to bring the procedure mainstream as a medical necessity.


In the field of facial transplantation, the person-defining portion of our frontage is referred to as the "critical central face." These features -- eyes, nose, mouth, and chin -- are critical because they comprise the part that others recognize, the part responsible for expressing emotions and for facilitating human connections. Far as it may be from the recipient's native face (and also, surgeons are quick to point out, from resembling the organ donor who provided the flesh and bone), the new face redefines that person's life.

When you meet a face transplant recipient, you become immediately aware that you're talking to someone extraordinary. Connie Culp, who lost her original face to a bullet in 2004, is one of the two face transplant recipients who speak in the early morning of the third day of the Annual Meeting of the American Academy of Facial Plastic and Reconstructive Surgery. What renders their presence especially strange, amid presentations on "Fat Grafting for Facial Rejuvenation" and "Varying Midface Lift Approaches," is that they and their surgeons are being celebrated not for having been brought tantalizingly close to an ideal of beauty, but because they remind those present why faces are taken so seriously to begin with.

The most extraordinary thing about meeting a face transplant recipient like Culp is the fact that you're able to recognize her as a person at all.

The awareness that you're in the presence of greatness comes differently with the four doctors on the panel, all of whom are partly responsible for this major scientific advancement, first performed in France in 2005 and of which there have since been 24 more instances worldwide. At first glance the surgeons -- Drs. Bernard Devauchelle and Sylvie Testelin, who were on the team that performed the very first procedure, Dr. Jean Paul Meninguad, who, with seven procedures under his belt, is the world's most experienced facial transplant surgeon, and Dr. Daniel Alam, part of the team that restored Culp's face, making U.S. history -- appear fully ordinary. Alam, up close, is shorter than one might expect a giant in his field to be; the other three must apologize for their thick accents. But as they speak of what they have accomplished, backed up by video testimony, it becomes easy to recognize that they, too, are extraordinary.

And they, the doctors, all speak reverently of having witnessed something even more extraordinary: the real-life "It's Alive!" moment when a rubbery mask of flesh, reattached to a new head's major vessels, suddenly flushes with blood. They all describe the wonder of the moment, downplaying their own hard work in order to admit, "There's always a leap of faith when it actually works."

They describe smaller miracles too -- the first smile, which one patient surprised everyone with by pulling off earlier than expected. Another's newfound ability to go out in public and be noticed by no one. One patient speaks of his gratitude for having a job at a post office outside of Barcelona -- a miracle for anyone, he says, in Spain's current economic climate. As Alam speaks of what it means to be a face in the crowd, distinguishable from 200,000 others by the human brain, he tears up, and it feels genuine. A patient in a video characterizes receiving his new face as "the difference between living and surviving."

Presented by

Lindsay Abrams is an assistant editor at Salon and a former writer and producer for The Atlantic's Health Channel.

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