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Face transplant man Richard Norris has ‘life restored’

James Meikle 28 March, 2012

When Richard Norris first saw his new face in a mirror, three days after a 36-hour face transplant operation, he was lost for words. But his doctors expressed how he felt – “this is so cool,” one of his surgeons kept repeating. Norris, 37, had worn a mask since a gun accident took away his lips, nose and the front part of his tongue in 1997.

His vision was not badly affected by the accident so, as soon as possible after his surgery at the University of Maryland Medical Center, he asked to see the results of the operation. On the same day, he told them that he could smell too. The operation took place on 19 and 20 March. A week later, he was able to brush his teeth and shave. His new face, said lead surgeon Eduardo Rodriguez, is “a combination of two individuals”.

Norris is the twenty-third person to have had a partial or full face transplant. The first was performed in France, in 2005, on a woman who had been attacked by her dog. A picture of how Norris looks now shows how his face has changed since his high-school graduation in 1993, and since the gun accident that destroyed much of his face.

Norris had been living as a recluse, avoiding eating in public and shopping for groceries at night. Since the accident, he has not had a full-time job and has already had numerous operations. “This accidental injury just destroyed everything,” said Rodriguez. “His friends and colleagues went on to start getting married, having children, owning homes. He wants to make up for all that.”

The operation involved more than 150 doctors, nurses and other staff. It was part of a remarkable 72 hours in which surgeons also transplanted a heart, both lungs, a liver and a kidney from the same anonymous donor, to other patients. For Norris, the surgeons transplanted teeth, the upper and lower jaw, a portion of the tongue and all facial tissue from the scalp to the base of the neck.

The most dramatic moment, according to Rodriguez, was after the team had removed all previous attempts to reconstruct Norris’s face. All that was left was part of his tongue and minimal protection for his eyes. That was the point of no return. “At this point we had to be successful.” Now, however, Norris’s face will need only minor, outpatient procedures.

Many developments in Baltimore have been made possible by US defense and naval research departments, which have provided funding for face and hand operations for wounded soldiers. More than 1,000 soldiers have been injured in Iraq and Afghanistan and the government believes up to 200 may be eligible for face transplants. Doctors say they hope to operate on military patients soon.

Norris was chosen from five potential patients, said Rodriguez. The selection process included psychological testing. He described Norris’s reaction to seeing a mirror “as one of the most emotional moments for him as well as for all of us. He put down the mirror and thanked me and hugged me, which was a wonderful gift …” The operation, said Rodriguez, had “restored the 15 years he had lost. We are making him a functioning member of society again.”

Rolf Barth, a transplant surgeon, said researchers had found there were fewer rejections with transplants involving a large amount of bone marrow with its own blood supply. Norris would have to take drugs for the rest of his life to stop his body from rejecting the face. “This was the perfect patient to put into practice what we had discovered in the laboratory,” he said.

Rodriguez, at a press conference to explain the surgery, said: “It is a surreal experience to look at him. It’s hard not to stare. Before, people used to stare at Richard because he wore a mask … Now they have another reason to look at him, and it is really amazing.”