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Dr. Schwartz Comments Face Transplant | Industry News from Palm Beach

04/04/2012 by Dr. Michael Schwartz

Richard Lee Norris’ Face Transplant Becomes Most Extensive in Medical History

Fifteen years ago, 22 year old Richard Lee Norris of Hillsvale, VA was involved in a gun accident that destroyed his face. The use of his mouth became limited, and Norris lost his lips, nose, and teeth after the unfortunate event. Now 37 years old, Norris has become only the 23rd person in medical history to receive a face transplant, and the first to receive one that is so extensive. Not only were the missing parts of his face replaced, this surgery also restored his upper and lower jaws and parts of his tongue, giving the man an entirely new face from the neck up.

The surgery – the first of its kind – took more than 150 doctors 36 hours to complete, and was performed at the University of Maryland Medical Center. Although there have been other facial transplants in the seven years that the procedure has been performed, this one is by far the most extensive and thorough. The skin and features were not the only parts of the face transplanted, as these specialized doctors and surgeons also had to replace nerves and muscles, ensuring that not only would Norris have a new face, but that it would also function.

From the first partial transplant in France to the first face transplant in 2008 at the Cleveland Clinic, doctors have sought to perfect their techniques and procedures. When reconstructing facial features, doctors simply try to recreate what was already there and still remains, but with a total facial transplant, it is imperative that not only are the features enhanced, but that the recipient can use them. In previous cases, recipients have regained feeling in the transplanted areas, but not always movement. This is the reason that surgeons must be extremely critical of how they perform the procedures, which will ensure that patients like Norris gain the most from the surgeries.

As there is a risk for complications from a surgery this extensive, candidates for this procedure are required to undergo testing to ensure that they can physically and mentally handle the transplant, and the possible after effects. These include infection, a failed transplant, rejection of the new face, and swelling, bleeding, or reactions to the medications given. In the past transplant surgeries, infections were common, but were also easily treated with antibiotics, and the transplants were successful. As Norris’ was the first total facial transplant, and the other 22 were used to repair only partial disfigurement, the studies that have previously been done only give a basic idea of what he should expect during his recovery process.

Although he had a job at the time of the gun accident, he has been unemployed since, and had to move into his parents’ home. After his accident, Norris became a recluse and only left his home at night while wearing a mask to do his shopping. During this time, he underwent many surgeries to help save his life and attempt to reconstruct his face. Now, after fifteen years and this full facial transplant, it is possible that he will be able to live a normal lifestyle and go out in public at any time. Only a few days after the surgery was performed, his sense of smell was regained after fifteen years, and just a week later, Richard Lee Norris is able to open and close his mouth, and has begun to brush his new teeth.

For the first time in years, he is also shaving his face, and doctors say that within a few months, he should regain at the very least partial sensation in his face. It is also hoped that over time, as Norris’ body accepts the transplant and it becomes more a part of him, it will transform to become a combination of his original face and that of the donor. This new face for Richard Lee Norris will offer him the ability to make up for lost time, and give him the chance to lead a real life – something he truly deserves after so many years of living in the shadows.

The process of facial reconstructive and full facial transplant surgeries is a relatively new one in terms of medical history, but the desire for doctors to help their patients is not. A steady pool of candidates like Norris will ensure that this procedure – and others like it – become much more standard medical practices and can help a greater number of those in need.


While Dr. Schwartz did not participate in the face transplant on Mr. Richard Lee Norris he had the following comments on this surgical breakthrough:

These are miraculous procedures that are truly life changing. Major credit needs to be given not only to the surgeons who perform the transplant, but to the donor families who make this precious gift. Although not often written about the donor surgeons create a life like prosthesis for the donor to leave him or her in a respectful state for the family.

In this current climate of debate about the future of our health care system, these cases illustrate more than any others how a small number of people can truly need and deserve the effort and sacrifice of the many. It represents everything that is noble about medicine.

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