New three-dimensional imaging techniques are helping lower the hurdle.
A new study on the procedure led by University of Pittsburgh Medical Center resident Darren Smith demonstrates that surgeons are better able to assess the facial structure and contours, as well as the underlying bone, muscles, nerves and vessels, when they combined information from multiple imaging exams to create a single, sophisticated 3-D computer model.
Today, facial transplantation preparation begins with a plastic or plaster model created from a 3-D CT or angiographic image. From this, surgeons perform mock dissections to prepare for the real thing.
Computer modeling software aims to improve this, combining medical imaging information from 3-D CT, CT angiography, MRI and high-definition tractography. It's the same kind of technology used in the film industry to give animated characters human expressions.
Because surgeons can manipulate the anatomy of the 3-D model using computers, it helps them plan for exactly where bone, blood vessel and nerves will be cut and connected. It also gives them a picture of what the final result will look like.
That's a big deal for the procedure, which aims to not only restore basic functions -- breathing, chewing, speaking -- but appearance.