NATICK, Mass. (Jan. 5, 2012) -- What's in a face?
Plenty. If you doubted that, you simply had to listen to Dr. Bohdan Pomahac of Brigham and Women's Hospital in Boston, who spoke Jan. 3 at the Natick Soldier Systems Center.
"The face has very unique features, unlike any other human part," Pomahac told the audience at Hunter Auditorium. "There is nothing else that would be as easy to recognize as the face. It is a major, major source of social interaction. The facial area is really where pretty much all the human senses are located."
Pomahac has intimate knowledge of the subject. Since 2009, he and his team at Brigham and Women's have performed four face transplants on accident victims, including three full facial procedures made possible by Biomedical Translational Initiative funding through a contract issued by the Army Contracting Command-Aberdeen Proving Ground, Natick Contracting Division, in September of 2009.
"The goal was to have technology available within 18 months that could be used for our Wounded Warriors," said Cheryl DeLuca, chief of the Natick Contracting Division. "The work done in support of these face transplants will directly benefit our wounded warriors, making face transplants clinically available to them in the future."
"The Natick Contracting Division is proud of the relationship we have forged with Brigham and Women's Hospital and Dr. Pomahac's team and excited for what the future holds for our wounded warriors," DeLuca said.
Pomahac lauded Natick's involvement in his work.
"I think we're at the beginning of a new era in facial reconstruction," Pomahac said. "The initial support really came from the military funding. I think we are all feeling very, very fortunate that there is someone who sees the potential value in the future for the wounded warriors."
Pomahac's presentation at Natick included before-and-after images of the four transplant recipients. He then introduced Jim Maki, his first facial transplant patient.
"It takes an enormous amount of courage on the patient's side, as well," Pomahac said. "We don't really know all the answers. We're learning as we gain experience. Our patients, for us, are very special."
Pomahac pointed out that transplants from donors become the only options in the most extreme cases of facial injury.
"It is so complicated and in such a tight space that it's not even in the foreseeable future that we would be able to use some sort of man-made constructs," said Pomahac of the face. "We pay huge attention to reconnect all the motor nerves and sensory nerves that provide the sensation, the feeling of the face both on the surface as well as inside of the mouth."
Maki said he was pleased with how his transplant had turned out.
"Actually," said Maki, "I haven't been disappointed about any part of this."
Pomahac said that Maki had improved aesthetically and functionally since suffering severe burns in a 2005 fall onto an electrified subway rail.
"He has really regained sensation in the entire allograft," Pomahac said. "What I've seen over the years is fairly profound changes in personality. Now we can talk about the Red Sox for an hour."
Lessons learned by Pomahac and his team from Maki and other patients might one day help treat injured Soldiers.
"I think it will have tremendous potential applications for traumatic brain injury, stroke patients, for a variety of other brain conditions," Pomahac said. "We're learning that the nerves regenerate beyond what was thought to be possible. We want to see patients be able to reintegrate into society, or if it's a Soldier, to be redeployed and be able to return to active duty."
His successes so far have surprised even Pomahac.
"I'm amazed every day myself," Pomahac said. "It wouldn't be possible without your support, and it wouldn't be possible without the teamwork. No one of us knows how it is to live without a face."