Face Transplants: How The Hell...

Dallas Wiens, the first person in the US to get a full face transplant—yes, that means he now wears someone else's face—appeared in public for the first time today. Wiens face was obliterated in 2010 in a construction accident: he was using a cherry picker to paint the top of a church and accidentally ran into a high voltage electrical wire. After 15-hours of surgery, doctors gave him a whole new look plus the added bonus of restoring his sense of smell.

It sound pretty sci-fi—you just cut off someone's face and flop it down onto someone else's? 

It's not so easy. A full face transplant is not like a liver, kidney, or even a heart transplant where you can just cut it out and reattach somewhere else; the face contains muscle and nerve that must be re-attached as well, to render a face in working order.

Doctors have to make something like a topological map of the transplant recipient's face and where he or she need extra muscle and skin. Then, the donor's epithelial tissue, muscle, and nerve are cut to compensate for missing areas of the recipient's face. The recipient's skin would need to be prepped before the new face was laid on top, the outside skin and some of the underlying fat and muscle removed. Wiens' whole face would have had to been prepped this way. Recently-deceased cadavers serve as face donors.

 Evidently, even though you're wearing someone else's face, you don't necessarily look like them. A varying degree of underlying muscle and bone are still distinctly yours, and your expressions can remain similar.

Face transplants can restore function and a sense of normalcy to the lives of those involved in serious accidents. Dallas Wiens can smile now. He says it feels really great to breathe out of a nose after years of breathing through a stoma and even better to regain his sense of smell—the flowers smell so sweet now, he says.

Other face transplant recipients:

Sandeep Kaur, a 9-year-old girl who caught her face and scalp in a thresher, was technically the first person to get a full face 'transplant.' They attached her original face back on.

Oscar, a Spanish farmer who lost his face to a accidental shotgun blast, was the first full facial transplant in the world. March 2010 in Barcelona.

Isabelle Dinoire, maimed from a dog attack, received the world's first partial facial transplant. November 2005.

Connie Culp, disfigured from an accidental gunshot, was the first to undergo a partial facial transplant in the US. 2009.

Images by AP