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Evaluation of appearance transfer and persistence in central face transplantation: a computer simulation analysis.
J Plast Reconstr Aesthet Surg. 2010 May; 63(5):733-8.JP

Abstract

BACKGROUND

Partial facial allotransplantation is an emerging option in reconstruction of central facial defects, providing function and aesthetic appearance. Ethical debate partly stems from uncertainty surrounding identity aspects of the procedure. There is no objective evidence regarding the effect of donors' transplanted facial structures on appearance change of the recipients and its influence on facial recognition of donors and recipients.

METHODS

Full-face frontal view color photographs of 100 volunteers were taken at a distance of 150 cm with a digital camera (Nikon/DX80). Photographs were taken in front of a blue background, and with a neutral facial expression. Using image-editing software (Adobe-Photoshop-CS3), central facial transplantation was performed between participants. Twenty observers performed a familiar 'facial recognition task', to identify 40 post-transplant composite faces presented individually on the screen at a viewing distance of 60 cm, with an exposure time of 5s. Each composite face comprised of a familiar and an unfamiliar face to the observers. Trials were done with and without external facial features (head contour, hair and ears). Two variables were defined: 'Appearance Transfer' refers to transfer of donor's appearance to the recipient. 'Appearance Persistence' deals with the extent of recipient's appearance change post-transplantation. A t-test was run to determine if the rates of Appearance Transfer differed from Appearance Persistence.

RESULTS

Average Appearance Transfer rate (2.6%) was significantly lower than Appearance Persistence rate (66%) (P<0.001), indicating that donor's appearance transfer to the recipient is negligible, whereas recipients will be identified the majority of the time. External facial features were important in facial recognition of recipients, evidenced by a significant rise in Appearance Persistence from 19% in the absence of external features to 66% when those features were present (P<0.01).

CONCLUSION

This study may be helpful in the informed consent process of prospective recipients. It is beneficial for education of donors families and is expected to positively affect their decision to consent for facial tissue donation.

Links

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Authors+Show Affiliations

Pomahac B
Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. bpomahac@partners.org
Aflaki P
No affiliation info available
Nelson C
No affiliation info available
Balas B
No affiliation info available

MeSH

AdultAgedComputer SimulationElectronic Data ProcessingFacial ExpressionFacial TransplantationFemaleFollow-Up StudiesHumansMaleMiddle AgedPhotographyTransplantation, HomologousYoung Adult

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19398394

Clinical Trial Links

Face Transplantation for Treatment of Severe Facial Deformity

Citation

Pomahac, Bohdan, et al. "Evaluation of Appearance Transfer and Persistence in Central Face Transplantation: a Computer Simulation Analysis." Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, vol. 63, no. 5, 2010, pp. 733-8.
Pomahac B, Aflaki P, Nelson C, et al. Evaluation of appearance transfer and persistence in central face transplantation: a computer simulation analysis. J Plast Reconstr Aesthet Surg. 2010;63(5):733-8.
Pomahac, B., Aflaki, P., Nelson, C., & Balas, B. (2010). Evaluation of appearance transfer and persistence in central face transplantation: a computer simulation analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 63(5), 733-8. https://doi.org/10.1016/j.bjps.2009.01.078
Pomahac B, et al. Evaluation of Appearance Transfer and Persistence in Central Face Transplantation: a Computer Simulation Analysis. J Plast Reconstr Aesthet Surg. 2010;63(5):733-8. PubMed PMID: 19398394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of appearance transfer and persistence in central face transplantation: a computer simulation analysis. AU - Pomahac,Bohdan, AU - Aflaki,Pejman, AU - Nelson,Charles, AU - Balas,Benjamin, Y1 - 2009/04/23/ PY - 2008/12/11/received PY - 2009/01/16/revised PY - 2009/01/31/accepted PY - 2009/4/29/entrez PY - 2009/4/29/pubmed PY - 2010/5/26/medline SP - 733 EP - 8 JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS JO - J Plast Reconstr Aesthet Surg VL - 63 IS - 5 N2 - BACKGROUND: Partial facial allotransplantation is an emerging option in reconstruction of central facial defects, providing function and aesthetic appearance. Ethical debate partly stems from uncertainty surrounding identity aspects of the procedure. There is no objective evidence regarding the effect of donors' transplanted facial structures on appearance change of the recipients and its influence on facial recognition of donors and recipients. METHODS: Full-face frontal view color photographs of 100 volunteers were taken at a distance of 150 cm with a digital camera (Nikon/DX80). Photographs were taken in front of a blue background, and with a neutral facial expression. Using image-editing software (Adobe-Photoshop-CS3), central facial transplantation was performed between participants. Twenty observers performed a familiar 'facial recognition task', to identify 40 post-transplant composite faces presented individually on the screen at a viewing distance of 60 cm, with an exposure time of 5s. Each composite face comprised of a familiar and an unfamiliar face to the observers. Trials were done with and without external facial features (head contour, hair and ears). Two variables were defined: 'Appearance Transfer' refers to transfer of donor's appearance to the recipient. 'Appearance Persistence' deals with the extent of recipient's appearance change post-transplantation. A t-test was run to determine if the rates of Appearance Transfer differed from Appearance Persistence. RESULTS: Average Appearance Transfer rate (2.6%) was significantly lower than Appearance Persistence rate (66%) (P<0.001), indicating that donor's appearance transfer to the recipient is negligible, whereas recipients will be identified the majority of the time. External facial features were important in facial recognition of recipients, evidenced by a significant rise in Appearance Persistence from 19% in the absence of external features to 66% when those features were present (P<0.01). CONCLUSION: This study may be helpful in the informed consent process of prospective recipients. It is beneficial for education of donors families and is expected to positively affect their decision to consent for facial tissue donation. SN - 1878-0539 UR - https://www.unboundmedicine.com/medline/citation/19398394/Evaluation_of_appearance_transfer_and_persistence_in_central_face_transplantation:_a_computer_simulation_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1748-6815(09)00211-3 DB - PRIME DP - Unbound Medicine ER -