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Hillsville man receives face transplant

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Richard Lee Norris lost the lower part of his face in a gun accident in 1997. Last week, he underwent the most extensive facial transplant ever performed.

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BALTIMORE, Md. — Since losing part of his face in a 1997 gun accident, Richard Lee Norris of Hillsville, Va., has undergone multiple life-saving and reconstructive surgeries.
The 37-year-old lost his lips, nose, teeth and lower jaw in the accident, and had only limited movement of his mouth. For 15 years, he lived as a recluse with his parents, wearing a mask to cover his injuries in public and shopping at night.
Norris lived in Fieldale at the time of the accident in September 1997, when he noted that a 12-gauge shotgun inside the glass of a gun cabinet was askew, according to information The Martinsville Bulletin learned from the Henry County Sheriff's Office. When Norris opened the cabinet to right the shotgun it went off. Last week, at the University of Maryland, Norris received the most extensive full face transplant ever performed, including both jaws, teeth and tongue.
Dr. Eduardo Rodriguez, the lead surgeon, said the transplant will give Norris his life back.
The university released details of the historic surgery on Tuesday. A week after surgery, Norris is reportedly able to comb his hair and shave, and has regained his sense of smell, which he lost after the accident.
The 36-hour operation occurred on March 19-20 at the R Adams Cowley Shock Trauma Center and involved team of physicians from the University of Maryland School of Medicine and a team of more than 150 nurses and professional staff, according to a press release.
Though he has a face from a donor, photos of Norris post-surgery show a man who looks remarkably similar to a yearbook photo used for comparison, except for some scarring around his neck and scalp.
He will require some minor adjustments to the transplant, but Dr. Rodriguez said they will be outpatient procedures.
Norris will have to take immunosuppression drugs for the rest of his life to keep his body from rejecting the donated face, but the jaw transplant could mean he will need less and may be able to go off steroids, Rodriguez said.
The doctors have released little information about the face donor, who also donated other organs for transplant. And, Norris’ family is not doing press interviews at this time.
The face transplant team collaborated with the non-profit Living Legacy Foundation of Maryland to obtain the face for transplant.
“The family of an anonymous donor generously donated his face and also saved five other lives through the heroic gift of organ donation,” the press release said. “Four of these transplants took place over the course of two days at the University of Maryland Medical Center.”
The facial transplant surgery is called a vascularized composite allograft (VCA).
Norris’ surgery was the 23rd face transplant performed since doctors began doing the procedure seven years ago. The first full face transplant was performed on a woman in France in 2005.
The transplant team was led by Dr. Rodriguez, associate professor of surgery at the University of Maryland School of Medicine and chief of plastic, reconstructive and maxillofacial surgery at the shock trauma center.
Dr. Rodriguez is board-certified in plastic and reconstructive surgery as well as in oral and maxillofacial surgery. This marks the first time in the world that a full face transplant was performed by a team of plastic and reconstructive surgeons with specialized training and expertise in craniofacial surgery and reconstructive microsurgery, according to the press release.
“We utilized innovative surgical practices and computerized techniques to precisely transplant the mid-face, maxilla and mandible including teeth and a portion of the tongue,” explains Dr. Rodriguez.
“In addition, the transplant included all facial soft tissue from the scalp to the neck, including the underlying muscles to enable facial expression, and sensory and motor nerves to restore feeling and function. Our goal is to restore function as well as have aesthetically pleasing results.”
Norris first came to the University of Maryland Medical Center in 2005 to discuss reconstructive options with Dr. Rodriguez.
Grant funding from the Office of Naval Research (ONR) in the Department of Defense has supported the university’s face transplant research, leading up to this groundbreaking surgery.
The ONR funds medical research to support military operational medicine and clinical care of returning veterans.
“The face transplant is a perfect example of the life-changing options we can provide for our patients when we combine the expertise of our research and clinical teams to pursue procedures that would have seemed unfathomable not so long ago,” said Dr. E. Albert Reece, vice president of medical affairs at the university and dean of the University of Maryland School of Medicine.
The team of face transplant surgeons benefited greatly from their experience treating high-velocity ballistic facial injuries at the shock trauma center. The team also includes research scientists and physician scientists from the University of Maryland’s nationally recognized Division of Transplantation, who have been researching ways to reduce rejection of donated organs and minimize the side effects of long-term immunosuppressive use after transplantation.
“This accomplishment is the culmination of more than 10 years researching the immune system’s response” to transplants,” said Dr. Stephen T. Bartlett, surgeon-in-chief at the University of Maryland Medical Center. “Our solid organ transplant immunosuppressive protocol has led to excellent outcomes for our patients and will be part of the long-term care plan for the face transplant patient.”

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