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Scarlette Wiens touches the chin of her father, face-transplant recipient Dallas Wiens. (Brigham and Women's Hospital )

First Full-Face Transplant Recipient In U.S. Returning Home

May 9, 2011

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Dallas Wiens says when he woke up after surgery in March, he asked a nurse if he could touch his new face. Told he could, he gingerly felt his eyelids, nose and mouth — all transplanted from an anonymous donor.

"I said out loud that this should not be medically possible — because it doesn't seem like it should be," Wiens said at a Boston press conference before going home to Texas. "But here I am today."

He's the first U.S. patient to get a full-face transplant, and only the third in the world.

Wiens, 26, looks nothing like he did before Nov. 13, 2008, when a horrific accident obliterated all his features and left him blind. He was painting a church from a cherrypicker crane when he brushed a high-tension power line, suffering deep and extensive burns.

Dallas plastic surgeons harvested skin from other parts of his body to cover the wound. But until the Boston transplant, Wiens' face was almost a total blank, a nearly featureless curtain of skin. He breathed through a hole in his throat.

Now he looks close to normal, with a goatee and a flawless nose — through which he can breathe and smell again — and a full head of hair. The transplant reaches from mid-scalp to neck.

His mouth has a pronounced one-sided droop, but surgeons hope that will normalize as his nerves knit together more completely with those in the donor tissue. His voice, now slurred but still understandable, should also become more articulate.

Last week his 4-year-old daughter, Scarlette, saw his new face for the first time. "She was amazed," Wiens says. "She actually said, 'Daddy, you're so handsome.' To her, I'm still Daddy. That in itself is an amazing gift."

Wiens will have to take immune-suppressing drugs for the rest of his life, which increases his risk of infections and cancer. But he accepted the risk for the chance "to start over again," as he told the Boston Globe. He hopes to go to college, and he's been working on a novel.

Until now face transplants — partial and full — have been occasional oddities. But that may change.

Since Wiens' operation in mid-March, Brigham and Women's surgeons have done another full-face transplant on an Indiana man named Mitch Hunter, who suffered severe electrical burns from a power line after a motor vehicle accident in 2001.

A woman named Charla Nash is on the waiting list. She lost her nose, lips, eyes and fingers in February 2009 when she was mauled by a chimpanzee. The hospital said in Feburary that she has been approved for transplants of her face and both hands, pending identification of a donor who is a good-enough tissue match.

The Boston hospital has a $3.4 million grant from the Defense Department to perform six to eight face transplants, with one goal being the developing of best practices for future operations.

Plastic surgeon Bohdan Pomohac of Brigham and Women's says there may be hundreds of candidates for full or partial face transplants, but no one knows for sure.

About a dozen of the procedures have been done worldwide. Before Wiens and Hunter, other full-face transplants were in Spain and China. Cleveland Clinic made headlines in 2009 when doctors there performed the nation's first partial face transplant on Connie Culp, whose husband shot her in the face before turning the gun on himself.

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