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Beauty at High Cost
Cover Stories Series 2012> Beauty at High Cost
UPDATED: December 20, 2006 NO.32 AUG. 10, 2006
Saving Faces?
As China's first facial transplant patient is recovering, debate on the ethics of such a surgery continues

On July 28, China's first facial transplant patient, Li Guoxing, was released from hospital 100 days after undergoing a successful surgery in Xi'an, Shaanxi Province.

The transplanted part of Li's face is alive and he has been doing very well, Guo Shuzhong, Director of Xijing Hospital's Plastic Surgery Department, was quoted by Xinhua News Agency as saying. Guo directed the 14-hour operation on April 14.

Since French surgeons conducted the world's first face grafting operation last November on a woman disfigured by a dog bite, their Chinese counterparts have been in a competitive mood, angling to be the first to undertake such a controversial procedure in China.

In April, Xijing Hospital came out ahead as it performed the first face transplant on Li, a 30-year-old farmer from a poverty-stricken village in southwest China's Yunnan Province.

"I cannot believe this is real," said Li at his first public appearance after his damaged face was restored.

Deeply scarred

In 2004, while herding sheep on a mountain near his village, Li was attacked by a bear, which scraped half of his once clean-cut face.

"It was an ugly face beyond imagination. Without the nose or the upper lip, all his teeth were exposed. Half of the face was damaged beyond recognition," said the lead surgeon Guo, describing his shock at seeing Li for the first time despite his broad experience in dealing with similar cases.

Li went through numerous facial plastic surgeries after the accident, but they didn't have much effect. In the two years after his accident, Li suffered from the psychological damage of ostracization. He chose to walk on the edge of the street, his face pressed against the wall, so as not to scare passers-by. Li said that sometimes he felt like a dead man walking.

"Many people who survive accidents but are disfigured will die slowly from isolation in society," said Guo, a veteran surgeon.

Plastic surgery in China was energized by the attention given to the facial transplant in France. Surgeons in Beijing, Shanghai and Nanjing have launched their own facial transplant plans.

The possibility of grafting one face onto another ignited hope in Li's heart. Funded by the Nature Conservancy headquartered in Washington, Li was admitted into Xijing Hospital on March 11 for a grafting operation. Doctors at the hospital were previously known in China for successfully transplanting the face of a rabbit onto another.

The hospital's ethics board examined a report submitted by the transplant surgery team in advance, covering the odds of success, what could go wrong, how to deal with such situations and what is the worst-case scenario. After the ethics board ratified the plan for the operation, it was registered with the local health authorities, marking the official activation of the facial transplant project.

"The operation in France greatly boosted our morale," Guo said.

Doctors found a face donor a month later, who, according to the hospital, was a brain-dead male. Li went into surgery on April 14, an operation that involved 10 surgeons and gave him a new cheek, upper lip, nose and an eyebrow. Xijing Hospital then declared Li to be the world's first man to receive a face transplant.

Han Yan, another lead surgeon of Li's operation, said there is no essential difference between Li's operation and the facial transplant in France, except for that Li's transplant is more difficult than that of the Frenchwoman. The female recipient in France had lost her nose, lips and jaw while the first face transplant surgery in China involved reconstructing a half-smashed face and the removal of two thirds of facial skin.

Challenges to overcome

Han also revealed an interesting detail about the operation. Ten hours after surgery, due to the restoration of blood circulation, hair started to grow on Li's transplanted skin. Li's family wanted to shave it with an electric razor, but to avoid infection, nurses cut the hair every day with a pair of surgical scissors.


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