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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
Face Forward
As China's first facial transplant patient is recovering, debate on the ethics of such a surgery continues

Last November, surgeons in France successfully performed the world's first face transplant surgery. Ten days later, Chen Huanran in Beijing began soliciting patients who were ready to accept a face transplant, searching for China's first such patient through an advertisement on his website and other channels.

Chen, chief orthopedic surgeon at the Plastic Surgery Hospital under the Chinese Academy of Medical Sciences, has conducted more than 300 transsexual operations and was considered one of the top competitors in the running to perform China's first facial transplant surgery. However, surgeons at Xijing Hospital in Xi'an were first, performing a partial face transplant on Li Guoxing in April.

Beijing Review reporter Feng Jianhua recently spoke with Chen on the future of face transplants in China.

Beijing Review: There are reports that China's first face transplant surgery has been a success and it is claimed as the world's first male face transplant. As an experienced plastic surgeon, what do you think of this event?

Chen Huanran: The success of the face transplant operation is a breakthrough for plastic surgery in China so we should admit its positive value. However, we should also give a concrete analysis of the discussion of the world's first male face transplant surgery. If a female face is successfully transplanted onto a man's face, the surgery will have history-making significance. If the surgery only transplants a male face to another man's face, it is pointless to make a fuss about the gender of the recipient. In fact, China's male face transplant surgery is no different from France's female face transplant surgery in terms of clinical technique.

China still has no integrated national certification system to establish whether surgery can be performed or not and what are the standards of success. I think the face transplant in Xi'an has only achieved success in terms of changing a face and has no practical meaning because such an operation can be successfully undertaken at almost all provincial hospitals. The key of the surgery, and the biggest problem as well, is for the patient to regain all kinds of facial functions and this takes at least six months. Hence, I think that we should not be too optimistic about China's face transplant.

At present, face transplant surgery has become a hot topic around the world. How do you define "face transplant" and what do you consider the standard of success?

Face transplant surgery is a hot topic mainly because, compared to other parts of the body, the face has many special features and is always paid more special attention as an important symbol of a person's contact with others.

According to reports, an international definition of "face transplant" will be determined in the near future. I think that a real "face transplant" refers to the anatomical transplant of the whole face, including all organs of face, but not a partial transplant.

In my opinion, the success of face transplant surgery relies on the thorough change and reconstruction of the facial skin, subcutaneous tissue, muscles, bones and nerves and blood circulation systems.

What are the main difficulties for face transplant surgery at present?

There are many problems that have not been solved. We can even say that we have only edged toward a proper face transplant. The first problem is immuno-suppression and rejection. Although such a reaction will appear in transplants of all kinds of organs, it will be much more serious for the skin because skin is the most sensitive part of the body.

Face transplant surgery faces four main problems--recovery of nervous function, facial expressions, and color and sensitivity of the skin. After the surgery, although all blood vessels have been connected, the nervous system may still have no function because nervous cells cannot regenerate themselves. Take muscles for example. Facial muscles have a memory function so that they still remember the original body's information and it is difficult for them to adapt to their new hosts. Under such conditions, psychologists and rehabilitation experts are required to participate in the treatment.

Since face transplant surgery is so problematic, why are you still actively preparing for it? Now that the first transplant has taken place in China, do you intend to further promote your plan?

As a kind of scientific exploration, everybody wants to be the first to do it. Such factors as underdevelopment in technology cannot stop us pushing forward to face transplants. However, we must abide by the principle that the advantages must outweigh the disadvantages. Given the problems I mentioned, the result of this operation may be harmful to patients but the exploratory spirit should be encouraged. Hence, if we keep the operation within a certain range, its advantages will be more than its disadvantages. That is, we should regard the operation as a scientific exploration but not as an experiment aiming to push the surgery into larger practice.

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