Blood & Guts – A History of Surgery: Fixing Faces

February 16, 2009
Michael Mosley performing a facial surgery technique on a Mannequin/dummy

Michael Mosley performing facial surgery on a mannequin/dummy

In the fourth part of the BBC 4 Blood and Guts series, Fixing Faces looks at the evolution of plastic surgery. True to form, Michael Mosley presents a graphic account of how brutal attempts to reconstruct patients’ diseased or damaged faces have led to a modern medical speciality which is now believe to be on the eve of the first full face transplant. This episode describes and illustrates the history of this area of surgery: showing the work of the 16th century Italian doctor Gasparis Taliacotii (00:05:06 – 00:18:02); the beginning of the Botox era (00:18:02 – 00:30:00); and the work of Sir Harold Gillies and Sir Archibald Mclndoe, who developed both surgical techniques and the need for psychological support for patients undergoing reconstructive facial surgery (00:30:00 – 00:50:00) (Please see this Student BMJ article – ‘A brief histoy of plastic surgery’).

This episode highlights two main ethical topics for discussion: functional Magnetic Resonance Imageing (fMRI) and Neuroethics (00: 01:54 – 00:05:06); and face transplants or facial allograft transplantation (00:50:00 – End).

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Blood & Guts – A History of Surgery: Spare Parts

February 11, 2009

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vlcsnap-146838Blood & Guts – A History of Surgery: Spare Parts is the third part of the BBC Four documentary series about the “brutal, bloody and dangerous history of surgery” focusing on the development of transplant surgery. The documentary primarily gives a graphic account of the history of transplant surgery, in particular focusing on the work of Alexis Carrel (00:04:24 – 00:22:47),  Joseph E. Murray (00:22:47 – 00:45:32) and Sir Roy Calne (00:36:40 – 00:45:32). However both at the beginning (Start – 00:04:24) and the end of the programme (00:45:32 – End) Michael Mosley (Also seen in BBC’s documentary series Medical Mavericks) discusses some of the ethical concerns that may arise from transplant surgery. Mosley meets with two patients who have both had a hand transplant, however only one of the patients is able to keep his new hand as it illustrates the success and failure of the radical surgery.

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Michael Mosley (00:02:00 - 00:04:24): "I'm really intrigued by David (patient because to me this is something more than just incredible surgery. The whole idea of living with a dead man's hand is one I find fascinating but also disturbing. A lot of people I've talked to are really freaked by the idea of having something like an arm transplant, its also true frankly of all the buts of the body that show like; noses, eyes, and faces probably the freakiest of them all. No other form of surgery impacts on our sense of self in quite the way transplants do. There is something profoundly strange about swoping body parts, melding your flesh with others. And these days there seems to be no limits."

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My Shocking Story – Human Face Transplant

November 13, 2008

At a military hospital in China, Professor Guo Shuzhong is striving to advance the necessary medical techniques to complete a full face transplant for one of his patients. Celebrated as one of China’s best plastic surgeons, Professor Guo is anxious to improve the lives of people with severe facial disfigurements.

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Professor Guo: "We Chinese pay a lot of attention to the face, if you have a problem with the face and go outside, a lot of people stare at you, look at you, you feel very uncomfortable... Some people are that disfigured that they do not look like human beings anymore. Some people in China call then ghosts. These patients are discriminated against in society; I deal with them every day and understand their suffering. They are in a great deal of pain. They do not expect to be beautiful after surgery, they just want a normal life again" (00:02:27 - 00:04:52).

Professor Guo believes that the only way to improve the life of his patients is to build on the well established techniques of plastic surgery and move towards partial and full face transplants. In November 2005 Isabelle Dinoire underwent the world’s first partial face transplant in France (00:12:34 – 00:13:32) (See Face transplant – Horizon). Professor Guo is encouraged by this and hopes that his research can build on the medical breakthrough.  

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A suitable donor? – Hollyoaks

January 23, 2008

I have to say from the outset that I am not usually a Hollyoaks fan and, as this post will show, I’m way off the pace as far as who’s who. However, turning on slightly early for the Channel 4 news on Tuesday 22nd January 2008 I happened to catch the end of that day’s episode of the Chester-based soap opera (TRILT code 007CA973) and was intrigued.  The storyline involved Charlie, a baby recently diagnosed with Acute Myeloid Leukaemia (AML) and in need of a bone marrow transplant. The first clip I caught was the doctor informing Charlie’s ‘dad’ Jake Dean that a blood test revealed he was not a suitable donor for the baby – on the grounds that he was not, in fact, the boy’s biological father.

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Frankie, Nancy and Jake

Recognising the potential benefit of this clip for teaching about transplantation and/or genetic testing, I decided I ought to check my facts.  This, it turned out, is more complicated than I had anticipated. So (deep breath) the woman standing anxiously by the baby’s bedside is not Charlie’s mum, she is Nancy, Charlie’s aunt (no pun intended). Charlie’s mum Becca is dead, stabbed in prison by her cellmate.  She was in prison having been found guilty of engaging in a sexual relationship with Justin, who was underage at the time. Despite the relationship being consensual, Justin made false claims of coercion based on his anger at being dumped by Becca. Justin is now with Katy Fox, Jake and Nancy are in a relationship of their own (keep up!).  Knowing about Becca’s infidelity with Justin, Jake had ordered a paternity test in January 2007, but decided not to open it, choosing instead to remain in ignorance and bring up Charlie assuming that he was the biological father.  This latest turn in the story shows that he is not. Read the rest of this entry »