Since the first successful surgery in 2006, face transplant procedures have become more standardized and better understood. In fact, they are now “currently feasible” for children; this new possibility has spurred an ethical dialogue among Canadian physicians. The procedure has the potential to radically transform the lives of children who suffer from devastating facial deformities and for whom no other reconstructive alternatives exist. “Facial transplantation offers a chance  – in a single stage – to alleviate much of that suffering with a single, albeit large and risky surgical procedure,” said doctors at Toronto Western Hospital.

In addition to the medical risks associated with the procedure itself, facial transplants require recipients to take immune-suppressing drugs for the rest of their lives to reduce the risk of tissue rejection, and such drugs come with their own health concerns; they’ve been associated with a heightened risk of developing cancer.

Facial transplants in children also involve complex moral issues such as informed consent, personal identity, and issues of “future resentment.” Recipients are not the only ones who must take into account philosophically weighty concerns; potential donors have their own moral issues to grapple with as well. For example, doctors at Toronto’s Hospital for Sick Children wonder, given the fact that the new face would have to come from a deceased child, whether or for what reasons parents would be willing to make such a donation. “Would a grieving mother donate her child’s face in the hope of one day ‘seeing’ her child again?” they ask. The donor and the recipient pair would have to be close in age because the transplanted muscle and tissue would have to grow along with the donor; additionally, the pair would have to be a match aesthetically.

Facial transplant procedures cost roughly $250,000, and this does not include the cost of lifelong immunosuppressant therapy.

While facial transplants are not considered life-saving like most, if not all, organ transplantation procedures are, this does not mean they don’t have the potential to be life-altering: “We know the devastation that people experience because they look so different,” said Anna Pileggi, executive director of AboutFace, a charitable organization that provides support for those living with facial differences. “Children and adults are taunted, bullied, avoided and socially rejected.”

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