Special Topic Prospects for Facial Allograft Transplantation in Humans

The face and scalp define functionally and aesthetically important units. Traumatic deformities of the head and neck region resulting from burn injuries, gunshot wounds, or ablative tumor surgeries may be presented as a single defect, such as of the skin, the subcutaneous tissue, or the muscle, or as a combination defect involving all three units. The optimal reconstruction of these specialized units is difficult to achieve. Sometimes, a major part of the face along with the entire composite subunit, such as the ear or the nose, may be involved.1–3 Extensive scalp loss due to burn or avulsion injury is another deforming and psychologically debilitating condition that presents a major reconstructive challenge. An ideal reconstructive procedure should replace the missing tissues as well as restore the motor and sensory function. Traditional reconstructive procedures include standard skin grafting, application of local flaps, tissue prefabrication, tissue expansion, and free tissue transfers.4–13 Despite application of meticulous techniques and artistic creativity, full functional and aesthetic reconstruction of the face is still challenging and rarely can be achieved. Here we present a brief overview of techniques applied for aesthetic and functional reconstruction of the facial and scalp region and a new approach to facial allotransplantation in humans.