Technical Aspects of Face Transplantation : Two Options for Total Face Harvesting

bACKGROUND: Acquired facial deformity can result from trauma, burns, and tumor resection. Conventional techniques such as skin grafts, local flaps, free flaps, tissue expansion, and prosthetic reconstruction provide satisfactory outcomes in most patients in need of facial reconstruction. However, final outcomes remain unsatisfactory in a number of cases, both from a functional and an aesthetic standpoint. Facial transplantation may become a theoretically viable option in the treatment of patients with extensive facial disfigurement.2 The challenges associated with immunosuppression and the ethical issues surrounding face transplantation are substantial.3, 4 One of the most significant technical questions that remains to be answered in face transplantation is how a facial allograft should be harvested and what tissues it can include. Two modalities of face harvesting are presented: myocutaneous and osteomyocutaneous.