Measuring Facial Landmarks Leads to Better Donor-Recipient Matching in Facial Transplant Surgery, ASPS Study Finds

SAN DIEGO -- As face transplants become more of a viable option for people suffering from devastating burns and other severe injuries of the face, plastic surgeons are working to better match potential donors with recipients. According to a new study being presented at Plastic Surgery The Meeting, the annual scientific meeting of the American Society of Plastic Surgeons (ASPS), Oct. 11-15, in San Diego, measuring five specific facial landmarks, prior to face transplant surgery, can better predict suitable donors and provide better outcomes.

"Although there have been many advances made in facial transplantation, reproducible methods of predicting donor-to-recipient match would be very useful, as it can take many months to locate an appropriate donor," said Bohdan Pomahac, MD, ASPS member surgeon and study co-author. "We found that if certain facial measurements were off by as little as one millimeter between donor and recipient, they were not the best match for transplant surgery."

In the study, 61 virtual (3-D) face transplantations were performed, representing donors and recipients of varying ages and genders. In order to assess donor-recipient compatibility, nine soft tissue measurements of the face were taken from each before virtual transplantation. Corresponding portions of the virtual donors' faces were transplanted to fill specific facial defects in the virtual recipients'. Twenty independent reviewers then evaluated the level of disfigurement that remained post-transplant. The difference in soft tissue measurements between the donor and recipient were then correlated to the remaining degree of disfigurement as rated by the reviewers.

A one millimeter difference in five soft tissue measurements were predictive of the virtual transplants being rated by reviewers as "very disfigured," compared to those rated "normal" or "mildly disfigured." The five soft tissue measurements included: down the middle of the forehead, inner corner of the eyes where the upper and lower eyelids meet, outer corner of the eyes where the upper and lower eyelids meet, the distance or area from the nose to the chin, and mouth width.

"Our study provides early evidence for the importance of soft tissue measurements in the planning of facial transplantation," said Dr. Pomahac. "With future improvements to immune suppression and increased donor availability, matching soft tissue landmarks may be an additional factor used to optimize post-transplant outcome."

In addition to the soft tissue landmarks examined in the study, the authors have conducted measurements of bony landmarks of the face which will also be presented during the meeting.

The study, "Anthropometric Facial Measurements for Predicting Donor-to-Recipient Suitability in Face Transplantation," is being presented Saturday, Oct. 12, at 10:50 a.m. at the San Diego Convention Center.

Reporters can register to attend Plastic Surgery The Meeting, or arrange interviews with presenters, by contacting ASPS Public Relations at (847) 228-9900, media@plasticsurgery.org or in San Diego, Oct. 11-15, at (619) 525-6330.