At the All India Institute of Medical Sciences (AIIMS), New Delhi, surgeons are preparing to attempt a procedure that goes far beyond surgical complexity. It aims to restore identity, dignity and the possibility of a normal life.
Fewer than 50 medical teams worldwide have successfully performed face transplant surgeries. Soon, India may join that group.
The proposed programme at
AIIMS will be led by the Department of Plastic, Reconstructive & Burns Surgery. According to the institute, the department performs over 8,000 procedures annually and more than 250 complex microsurgical reconstructions each year.
Addressing a recent press conference, Dr. Maneesh Singhal, Head of the Department of Plastic, Reconstructive and Burns Surgery at AIIMS, said that surgery is being planned for patients with facial disfigurement caused by burns, trauma or congenital conditions, especially those for whom reconstructive surgeries have failed.
What is Face Transplantation?
Speaking to Firstpost, Dr Singhal said, “Face transplant is a multi-team project, where multiple teams work. Anybody who has severe facial deformity with even inability to perform basic functions like eating, breathing or something like that and even after multiple
surgeries there is no solution, so in those patients face-transplant is something which is happening all over the world.”
Delineating on whether there is a difference between, plastic surgery and face transplantation, he said, “This is basically reconstructive surgery because somebody who has severely deformed face, where the routine body parts cannot replace that face, usually we will try to use something from the own body to replace it.”
He further said, “But in these cases nothing is available and no procedure is possible within the available body parts. Hence, a different face is taken up from a category of course based on consent, like we take kidney, liver,
heart. Similarly face transplant is one of the procedures.”
Several studies find that the history of facial reconstructive surgery has progressed slowly and naturally and is punctuated by highlights from sudden profound changes.
Facial transplantation has only recently become possible through the discovery of innovative drugs and the courage of innovative surgeons.
John Hopkins Medicine notes, “A face transplant is a complex procedure and involves: a rigorous screening process, detailed surgical preparation,16 hours or more of surgery, nerve regeneration, physical therapy and immunosuppressive medications taken for the rest of the patient’s life.”
Beyond just an aesthetic choice
This initiative would be exclusive to people who really need it.
Dr Singhal said face transplantation is not meant for everyone and involves lifelong follow-up. “There is a
medical board, we do investigations, medical board is there. Then after that we do investigations, then psychological testing.”
Usually the follow-up is all throughout life, it is not something which one can get rid of after doing a procedure. The whole life follow-up is there.
“There are a lot of discussions which happen between the family and the patient before they can become a fit candidate for that procedure. And it requires long-term medications, which have their own side effects. It’s a protocol which is followed when we select such patients.”
Speaking about how the right candidate will be chosen for this procedure, Dr Singhal noted, “Identifying the right candidate and counselling becomes essential before considering them for transplantation.”
“Unmotivated, unstable patients,
patients with active infection and cancers are not the right candidates for the procedure”.
The need for such a programme is underscored by India’s burn injury burden.
Around seven million people in the country suffer burn injuries every year, with facial burns particularly common among women and children.
Kitchen accidents involving scalds or open flames, kerosene stove explosions, domestic violence and chemical attacks remain leading causes.
Burn injuries often result in severe disfigurement, high mortality and deep social stigma.
According to available estimates of the
National Crime Records Bureau (NCRB), India records around 6–7 million burn cases annually, though the lack of a national registry means many cases go undocumented.
On the case of acid attack related disfigurement, Dr Singhal noted “This procedure is not specific to acid attack victims but they will also get benefited. There is no doubt about that. Acid attack victims also have a lot of facial deformity. But this is for every patient who requires a procedure.”
Legal frameworks and awareness
Speaking about the legal frameworks around the initiative, Dr Singhal said, “Legally, there is Organ Donation Act. There are regulatory bodies such as the National Organ and Tissue Transplant Organisation (NOTTO) and The State Organ and Tissue Transplant Organization (SOTTO). So, there is no regulatory confusion over this topic.”
“Awareness in patients, however is a big challenge,” he asserted. “To tell patients that this facility is available and invite patients coming to us is a big challenge.”
“I think that is where the media has a lot of role. Awareness is awareness so that anybody who can benefit with this procedure, if anybody can refer us or anybody can contact us, that will be great,” suggested Dr Singhal.
A pioneering initiative in India
He further said, “Globally, around 50 face transplants have been performed, largely in the United States. In Asia, the procedure has been reported in Turkey and China. “No centre in India is currently runs a full-face transplant programme.”
Face transplant at AIIMS would be a first of its kind initiative in India. “So, we are also embarking upon it very soon and we expect that we should be able to start that procedure in a year,” said Dr Singhal.
Summing up the significance of the initiative, he said, “Face transplantation is no longer experimental – it is the need of the hour”
If successful, the programme will mark a defining moment for Indian medicine, placing the country among a small group capable of performing one of the most complex reconstructive surgeries.
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