After a freak accident left his face horribly disfigured back in 2001, Mitch Hunter is now able to smile again. Hunter, a 30-year-old man from Indiana had a full face transplant at Brigham and Women's Hospital in Boston, only the third such operation done in the U.S.
"It was a full face transplant, including the skin between the ears and from forehead to chin," said Dr. Bohdan Pomahac, one of Hunter's surgeons and the director of plastic surgery transplantation at Brigham and Women's Hospital. Surgeons also transplanted Hunter's nose, lips and the nerves that allow for feeling and facial animation.
Back in 2001, Hunter suffered severe electric shock from a power line after a motor vehicle accident. Now, after the 14-hour surgery last week, doctors say he is doing well.
"So far, it's been excellent," Pomahac said. "He has already been discharged, and everything has gone smoothly."
The hospital did not release the exact date of the procedure in order to protect the privacy of the donor and the donor's family. The New England Organ Bank in Waltham, Mass. was able to get the family's consent to take tissue from the donor.
Hunter did not want to talk to the media, but his family did release a statement through the hospital.
"The Hunter family is truly grateful to the donor and his family for this amazing gift. We respect and admire their courage and intend to honor them by continuing in their giving spirit."
Hunter's operation comes less than a month after a Texas man, Dallas Wiens, had the most complete face transplant in the country, also at Brigham and Women's Hospital. The hospital has also done a partial transplant on a man who fell face first onto an electrified subway rail.
Although Pomahac says Hunter's prognosis is excellent, doctors will have to monitor him closely for signs of infection and rejection of the donor tissue.
Hunter is taking large doses of drugs to prevent rejection, but the drugs suppress the immune system and increase the risk of infection.
Since transplant patients have to remain on these drugs for the rest of their lives, there are longer-term concerns as well.
"The risk of developing a cancer remains high in the long run because of the immunosuppression," said Dr. Henry Kawamoto, clinical professor of surgery at UCLA's David Geffen School of Medicine. Kawamoto is not involved in Hunter's treatment.
Kawamoto also said that over time, patients who have face transplants may need additional operations.
"Surgical revisions will remain a possibility as well as the psychological adjustment that the patient will need to make."
In addition to Hunter's operation, there have been two other full face transplants and one partial transplant in the U.S. Surgeons say transplantation technology has been around for decades, but it's only recently that other changes have made the success of these operations possible.
"In the last few years, we have had more powerful anti-rejection medicines available," said Dr. Joseph Losee, director of the Facial Transplantation Program at the University of Pittsburgh Medical Center.
In addition, attitudes toward these transplants have changed.