Saturday, December 17, 2005

Face Transplant

The recent partial face transplant performed in France reminded me of the time I was the medical advisor for the movie Face/Off in 1996. The director that initially signed on to direct the then-untitled film ,Italian director Marco Brambilla, came by my office to discuss the project. I just assumed that we were talking about a relatively low-budget production. We discussed how we would portray the procedure on film and Marco toured my office and operating room taking photographs of the facilities and equipment. As Marco left, I wished him good luck in Hollywood, thinking that he was new to the United States and that he must be excited about directing what I presumed was one of his first movies.

Two days later, I am reading an article in the entertainment section of the LA Times about Sly Stallone. As I am reading the article, there is reference to the director of Stallone's big budget film Demolition Man. The director was none other that Marco Brambilla. I began to think that this small sci-fi film about two people exchanging faces may not be so small after all. Marco must have thought it was strange that I wished him good luck in Hollywood!

A few months later, I get a call from John Woo, the new director of what was now called Face/Off. Marco was off the project. John said that they had signed Nic Cage and John Travolta to star and that they were ready to start shooting. "Will you be able to come over to the set at Paramount to advise us on how to portray the procedure of Nic and John trading faces?" I agreed to come to the set the following Saturday and I arranged for a Coherent carbon dioxide laser to be delivered to the set. The CO2 laser looked high tech and would fit the role perfectly. I was trying to decide how to portray the procedure on film. Should I go with a realistic portrayal of a face transplant or with an imaginary, sci-fi type procedure?

John Woo, the cast and I discussed the options and we decided that the best way would be a stylized, sci-fi approach based loosely on real surgery. We decided to use the CO2 laser in a realistic way to make the incisions for the face transplants, but we decided not to get into more of the specific anatomic maneuvers that would be used someday in a real face transplant. I explained to the cast and crew that we would some day in the future be performing face transplants just like we perform liver transplants and kidney transplants today. In real life, we would not only transplant the face, but we would also need to transplant the arteries, veins and nerves of the face. We would also need to prescribe medications that would prevent the recipient from rejecting the new face. Although we all agreed that this was a very an exciting concept, but we felt that keeping things simple would be preferable for the movie.

It seems like only yesterday that we stood on the Face/Off set at Paramount talking about how someday in the distant future, a real face transplant would be performed. Little did we know that only eight years later, an actual face transplant would be performed on a real patient in France.
 
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