Face Transplant Could Be Cost-Effective

Jan. 30, 2011— -- Face transplantation -- at least in the near-term -- may not cost much more than the multiple conventional reconstructive surgeries that a complex case would need, according to the team that did the first U.S. face transplant.

That near-total face transplant done in 2008 for a woman injured by a shotgun blast cost $349,959 compared with $353,480 for the 23 separate conventional reconstructions she had done before transplantation.

The post-transplant costs added an extra $115,463, but the overall cost was "similar," said Dr. Maria Siemionow, the reconstructive surgeon who led the transplant team at the Cleveland Clinic.

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Moreover, the piecemeal reconstructions hadn't offered good results, Siemionow and colleagues reported online in the American Journal of Transplantation.

"Although the cost of facial transplantation is considerable, the alleviation of psychological and physiological suffering, exceptional functional recovery, and fulfillment of long-lasting hope for social reintegration may be priceless," the group wrote.

The 46-year-old woman had lost her nose and palate in the injury and had been unable to breathe, smell, taste, or eat normally. She remained so disfigured that she reportedly wouldn't go out in public despite four years of reconstructive surgeries.

The transplant from a dead donor replaced 80% of her face, including the cheeks, lower eyelids, nose, and upper lip as well as cheek and maxillary bone and some upper teeth.

The world's first partial facial transplant had been done in France in 2005 for a dog attack victim. The success of the French and U.S. cases spurred further facial transplantations, including the world's first total face transplant in Spain in 2010.

Siemionow's group had called for consideration of face transplantation as first-line treatment for severe facial trauma.

But, they noted in the journal article, "As face transplantation moves further away from the questions of 'can we?' or 'should we?', the question of fiscal responsibility will soon move into the forefront and may likely become the central issue of the face transplant debate."