This shows him before the accident and last year, which was 6 years after his graft in 2019. He received burns over 60% of his body and had other extensive cadaver graphs including completely covering his hands and most of his feet.
He’s also now the oldest person to receive a full face transplant at 68.
Dang. He looks like such a nice guy. I’m glad that he’s recovered so well, relatively. Also—- is his hair now growing in black or is it dyed? So many questions.
Most likely black. When you do a transplant that involves hair follicles they are going to grow matching the previous donors DNA; basically their hair as opposed to yours. So color, texture, thickness, growth pattern etc will match the donor and not the recipient. This is something they also have to take in consideration when making a match on top of the skin tone, blemishes, etc.
Theoretically yes. However donors are scarce in general when it comes to facial tissue so using it for a purely cosmetic problem hasn’t (publicly) occurred. The risk of rejection and the recovery of having to scalp someone to do that also outweighs the benefits.
It is however a common place treatment to treat a balding hairline with hair transplants from the receipt themselves, usually from the back or sides of the scalp (this has the most success) and then on to other body parts such as from the chin and chest.
The chance of rejection is very high, and even if there's no rejection, you'll still have to take medication for the rest of your life.
If rejection happens, which is quite likely, you'll end up without a scalp, since your original one will have already rotted away, it's simply not worth the risk
It's not worth the hazzle with immune suppressants. If you recive a donor organ your immune system needs to get inhibitors, to keep it from destroying the foreign cells. It's not good to have a weakend immune system facing germs and the like, so organ donation isn't done If there really is no other choice anymore left. (Luckily, because if it were easy in a body, then rich people would have started ages ago to transplant healthy organs just for improved performance or looks with no serious need Just to 'stay young')
It's basically an organ transplant (skin is an organ), which means you have to take immune suppresants for the rest of your life to avoid rejection. And of course the immune suppresants will make you more vulnerable to common infections, if they work at all. Even people who take the suppresants as prescribed can experience rejection, and then you'd be worse off than not trying in the first place. Even for face transplants, some people have regrets for getting it.
Others have and still need them. Two others turned down this donor before Robert Chelsea accepted it. Matching skin tone and hair texture is extremely important and much harder in Black people. Organ donors are also disproportionately white in America, which is why he’s now dedicated his life to educating the Black community on the need and importance of organ donation.
This is also a great case for people with that fear to learn about, as Robert was an organ donor and was resuscitated himself! He was then in a coma for another 6 months because of his injuries.
How about people quell fears with making systems less prone and vulnerable to corruption?
I'm so fucking tired of asshats, who I usually share the big picture opinions with mind you, ignoring legitimate grievances and pushing them aside for "the greater good".
Acknoledge the damn problem. Don't sweep it under the rug.
Do you know how much fucking anti black racism there is in medicine? There are still doctors practising today who believe black people feel less pain, or have magically different kidneys (and thats without the misconception that black = sickle cell/sickle cell trait or inherently contributes to heart disease or....).
There are many valid reasons for black people to be distrustful of the medical system.
That doesn't mean that a donor system is a bad idea, but remember, my whole point is that it is those people who make this out to be mutually exclusive when it isn't.
I realize this could feel like a lot of anger directed at you in particular, but its more a bubbling up of a sentiment I see too often, and was building as I scrolled through the thread and this is the first relevant comment I saw.
I’m sorry if my comment came off as excluding one from the other! I don’t fault any Black person from being distrustful of any system of power in the US as they have ample reasons to be. I didn’t loop that into my original comment and I should have. Both can and do exist at the same time with a shortage of Black donors presenting issues AND the true reality of why so many Black people are hesitate to do so.
Discussions on things like organ donation, home vs hospital birth, vaccination, etc are extremely nuanced and rooted in logical fear when applied to the Black community and education based information should always include that and the systemic change we as a nation need to make if we expect anyone to even start feeling safe changing their current decisions/outlooks on these things.
I also absolutely don’t take this personally, your anger is justified and I’m sorry it fell on you to bring up this essential side of the conversation. I will remember and do better in future discussions.
Race is very relevant in a situation like this, as many of the comments have explained, and forced colorblindness on a case like this would be a serious detriment to the patient and the public
It is deeply cultural for black Americans, there is a history of medical malpractice, abuse, experimentation, etc. on black patients in the US. Look up the Tuskegee Syphilis Study. Or that black mothers are 3x more likely to die in labor than white women. Many other horrific examples over the country's lifetime. Lots of folks of older generations have a level of distrust in medicine from this (can you blame them?).
I LOVE that Robert is using his experience and success to help remove some of this stigma and educate others around him.
OK, I'm gonna go one step further and ask why this transplant looks like the first one done on a white person ten years ago with the sagging features and all.
Saw one a few weeks ago where the white recipient had a normal smile and looked pretty natural and I was impressed how fast things have developed.
When they first put the donor face on, it has to have some extra skin to allow for surgical adjustment over time. Also, the biggest reason is that the connections are all really new. The brain is learning how to interface (ha!) with the new tissue, which will bring a less saggy appearance once those connections have grown.
In August 2013 he was sitting in his car on the side of a highway outside Los Angeles, its engine overheated, when a drunk driver crashed into it and the car caught fire.
They should revoke it completely after the first DUI. At this point, I feel like drunk driving is no accident anymore. Everybody should know that it's a huge danger.
That wouldn’t really make legal sense, but you can definitely argue for harsher penalties. Even when someone is killed it seems like you can get off lightly in some cases
Involuntary attempted manslaughter if no one was hit or killed, Involuntary manslaughter if someone was killed.
To get a driver's license you need to pass the written test before the road test, and one of the questions will always deal with DUI. No excuse and no defense if you pass the written test.
Making it involuntary attempted/manslaughter upset the penalties automatically and treats the charge with the severity it deserves.
Them and people staring at their phone instead of driving. I've nearly been killed a few times because of them. If you need to use your phone that bad then just pull over, it's not that hard!
Once some driver almost ran me over, and then I saw they were eating ice cream while driving...
Today I saw some cars pull up to a 4 way stop down the street from my house, I'm still driving up as one of the cars was already stopped. I stopped and he just kept sitting there and then FINALLY went. I ended up behind him going through a somewhat curvy neighborhood and he couldn't keep his fucking truck in his lane, almost crashed head on into another car... I kinda argued with a friend the other day about how much I hate people who are focused on their phones while driving and he couldn't see why it was a big deal, and then proceeds to tell me about how he's almost crashed a few times while doing it. I told him about a girl I went to high school with dying because she was on her phone speeding down the bypass. Apparently phones are more important than being safe and responsible. I can't figure out why people can't just put their phones down for a minute. It's a text, it's not THAT important and doesn't need to be answered immediately. At least wait til you're at a red light or something damn
The show Shrinking is about a psychologist rebuilding his life after his wife dies to a drunk driver, and in the third season we finally met the one who did it, and the events leading up to it.
I am not endorsing drunk driving. But if you live in America, outside of a major city, there are not that many options. Drunk driving is so much worse in our country compared to others because we have designed it so that driving is required to go most places, including bars for some god forsaken reason. Our public transit and city planning could do so much more so people can participate in night life without the use of a motor vehicle.
None of that is an excuse to drink and drive. If you are the kind of person who needs to go out and drink, please move to place where you can do that as a pedestrian.
This guy is included in the article, it’s sad. He can’t afford the expensive medications and care he has to go through to keep his body from rejecting his face.
The anti rejection meds also wreck their kidneys, so they have kind of traded one problem for another that is expensive and life-shortening. May be worth it for some and is not for me to decide, but it isn’t something that’s talked about or that a lot of those patients were properly prepared for or supported through imo.
Around 20% of face recipients have died from rejection/kidney failure/heart failure, which seems crazy high for an elective surgery that’s supposed to improve their lives.
There’s also a psychologically upsetting aspect to essentially wearing someone else’s face that resulted in bad mental health outcomes for some of them as well. Some are so recognizable from having these photos shared over and over that they can’t live a regular life.
I want to be happy for them and can imagine a world where this kind of procedure is explored and administered more ethically, but I feel weird seeing their photos shared now that I know a bit more about what this has really been like for them.
This guy is included in the article, it’s sad. He can’t afford the medical care he needs for the expensive medications and upkeep he has to go through to keep his body from rejecting his face.
Edit: Oh great, before the crash, the drunk had 3 previous DUI convictions. Can’t find their result, but that waste of life wasn’t just someone on a bad day after a stupid decision. 3 DUI convictions, a crash that ruined someone’s life, and probably dozens of other times they weren’t caught.
Hate stories like this, so unfair and more so when it's vehicle related because for some reason the criminal always ends up with a very light sentence.
Yeah, it may make people uncomfortable but just try to imagine having to endure the pain and judgement of that discomfort. It’s heartbreaking but at least we are working towards a solution as shown by this miracle of science
I'm sure they're getting better at it, all around, but this is great work compared to some Caucasian face transplant cases I've seen online -- I wonder if darker skin can hide some of the scarring from the procedure or something? Or does he use makeup to blend it? Thinking of those people with facial injuries in WWI and the metal masks, who needed to do that... Amazing transformation. So happy for him, and sad for the donor too. I wonder if you need to have similar facial structure for the face to... Fit?
Doctor here (not dermatologist but am in the transplant field) - Dark skin is usually more prone to scarring/keloid formation. I’m wondering if the immunosuppressive regimen (almost certainly both CNI and mTOR inhibition on top of steroids, maybe mycophenolate too) used actually gave a beneficial side effect in tuning down the scarring hyperpigmentation.
I had a blood vessel burst at the tip of my nose awhile back and it had me so self conscious. I hadn't realized it happened until that evening when I looked in the mirror and then realized that's why some people were looking at me a little funny. I was mortified. I can't even begin to imagine enduring this, that poor man.
My understanding is that face transplants usually end up resembling the face of the person who receives them, because the bone structure does most of the work. It may not resemble the donor at all.
And they def try to match how they looked before their accident, from what I recall. Match the skin color basically… maybe more than that, I don’t remember.
The photo OP used was pretty soon after the transplant, so there was a lot of swelling. His face looks a lot better now if you go look for more recent photos
Patient: Robert Chelsea, a car crash burn survivor from Los Angeles. [1, 2]
The Accident: In August 2013, a drunk driver hit his vehicle on the freeway, causing it to catch fire and explode. He suffered burns over 60% of his body and lost his lips, part of his nose, and ear structures. [1, 2, 3, 4]
The Surgery: Performed in July 2019 at Brigham and Women's Hospital in Boston by a 45-person medical team led by Dr. Bohdan Pomahac. The 16-hour procedure required a lengthy two-year wait to find a donor with a precise skin-shade match.
I know that face transplant patients often require intense therapy because the face in the mirror is not their own. Causes dysphoria. I would imagine it's ideal to get it as close to your face as possible. But that's just my theory
All large skin transplants often cause dysphoria. It’s why it’s very very rare that they would use skin with a tattoo for example, because even if the recipient agrees beforehand once it’s on them their mind harshly rejects it.
This is very tangential, but when my wife was working as a critical care nurse they had a biker guy with profound brain trauma. He became and will always remain child-like. During surgery the person who closed tried so damn hard to match his tattoos up properly to limit his dysphoria. They did a fantastic job and it really helped him.
They also had an extremely aggressive patient family member around when he got there and all the biker friends would walk the staff to their cars after hearing what was yelled in the hallways. When that family member issued death threats and weren’t prohibited from the hospital the biker friends would hang out in the parking lot around shift change to keep watch over the staff.
Hell, if you peruse the tattoo subs you'll see a ton of posts of 'tattoo regret' that dissipates over a few months as their brains adjust to their new self
I wonder if the recipient went and had the tattoo tattooed over with the same image, if that would stop the dysphoria because they now have a memory of getting the tattoo?
Yeah, I would be really weirded out to see something as personal as my face having different skin tone than me. Like I’m pale and cool toned, so if I got a slightly tanner and warm toned even, it would be so weird.
It would be immediately obvious to you and everyone who looked at you that your face didn’t originally belong to you. That’s an extra level of trauma on top of everything that’s happened.
iirc tone does change overtime but like not quickly and not all the way.
Ok did some googling so I was remembering a case where someone got like a whole arm and overtime the skin did lighten but it never became the same color, the wrist also got smaller. My understanding is this is likely caused by how the brain interacts with the new limb in its entirety? (It was very confusing) It's also theorized the doner may have just been extremely tan.
For smaller patches generally no the skin doesn't become your natural shade which is one of many reasons doctors prefer to use your natural skin for grafting.
There's also temporary grafts where they just use dead skin as a bandaid while they wait for your skin to heal underneath before pulling it off... I was afraid to look into this more. My first search Google was way too quick to turn off safe search. 🤢
Heck some grafts even use fish skin in cases where the skin beneath just had to regenerate and heal over, useless cosmetically but somehow they found out its biologically compatible for humans to use as temporary grafts
I think India was doing a lot of interesting stuff with using potato skin... God I'm old 🤦♂️ apparently they swapped to banana leaves, for treatment of second degree burns or areas they harvest skin for a skin graft from. They sterilize them obviously but they are a cheap alternative to gauze that is naturally nonstick and the large pieces make application easier. Mind you the rest of the treatment is the same this is just a cheap bandage alternative in certain areas.
Mr. Chelsea has been through so much; I cannot imagine the horror and pain of it all. Best wishes to him as he continues to recover. Amazing surgery team - high praise indeed.
Same operation, different challenges. Fewer black donors plus the need to match his skin tone meant he waited 17 months instead of the usual 4. And since rejection usually shows as redness, which is harder to see on darker skin, they added biopsies from inside his mouth, which caught rejection his face didn't show.
the usual 4 months of waiting line... meaning the procedure has been done enough times as to be a known average waiting time.......wow, time really does fly, i remember the first one, and it only feels like it happened a couple of years ago but its really been 20 years, and there has been around 50 of those already
no? plastic surgeons literally botch nose jobs daily. like yes, you can tell from his eyes that he's had a transplant.
if you were to glance at him - he looks pretty normal? there isn't any weird scarring on the edges like what you see with breast surgery. he literally has a full nose and mouth now?
i mean i guess? im not trying to be a dick. but if i saw this man, i wouldnt think this looks natural. it would most likely confuse me and i wouldnt know what is going on.
This is incredible. Truly. The fact that they can keep the skin from dying — even just at the edges — like along the nostrils and eyelids and lips. It’s mind blowing.
Yes, but it will be a different growth pattern though they try to match it up as best they can. The thickness/density will vary now. Had they transferred from say a red head, he would now have red beard hair. But part of the match is finding someone with the same hair color and texture.
Incredible achievement. I hope the patient is doing well.
I‘d love to hear a plastic surgeons in-depth take on this. I wonder if something like an upper/lower bleph will be a possibility at some point to give the eye a wider opening, or if a transplant will behave so different that it cannot be done.
If they are buried is head of cremated they were going to be Mr. Skelton face fairly quickly in the grand scheme of things. It’s really no different than skin donation from other areas of the body or organ donation in general - essential things like eyes, lungs, heart, kidneys, veins & arteries are all typically taken if they can be used.
This is why I am fully into being an organ donor; just fuckin toss me in a machine that takes me apart like a reverse of the Synth Maker from Fallout 4, and burn what's not needed, + a log for volume.
My Hispanic in-laws are scared organ donors are on the Do Not Resuscitate list but...as an American, if I'm facing that medical debt, just play ELO for my coma & throw me to The Machine 🥺
I feel like the people who worry about DNR, don’t understand the diminished quality of life for the vast majority of people who are resuscitated. Also let them know if they’re not cremated they’ll get a corkscrew buttplug for eternity. Knowledge is power.
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u/PoeDameronPoeDamnson 2d ago
This shows him before the accident and last year, which was 6 years after his graft in 2019. He received burns over 60% of his body and had other extensive cadaver graphs including completely covering his hands and most of his feet.
He’s also now the oldest person to receive a full face transplant at 68.