The first successful face transplant wasn’t that long ago. The November 2005 operation took place in France and was only a partial face transplant. Since then, there have only been a few dozen face transplant surgeries, including the famous case of Katie Stubblefield who was the US’ youngest recipient.
But until recently, the world hadn’t had a successful face transplant case for an African American patient. Robert Chelsea just became the world’s oldest face transplant recipient at 68 years of age, and also the world’s first African American recipient.
In August 2013, Robert Chelsea of Long Beach California noticed there was something off about his car while he was driving on a highway. Cautiously, he pulled over to see what the trouble was. But before he found out, an intoxicated driver lost control and rammed into Chelsea’s car, setting it aflame.
Chelsea spent the next four months in and out of consciousness at the University of California Irvine Medical Center while a medical team did the best they could to treat the third-degree burns he had suffered all over his body.
18 surgeries and many excruciatingly long days later, Chelsea was discharged from the hospital with severe scarring, two-thirds of his intestines missing, and the loss of much of his nose and lips due to necrotizing tissue. But fortunately, he was alive.
Chelsea’s medical team, including surgeon Dr. Victor Joe, relied on donor tissue to replace Chelsea’s severely damaged skin. Skin grafts are typically matched as closely as possible for the complexion as well as texture, especially for prominent areas like the face. But as far as Chelsea was concerned, his newly grafted skin never seemed to be the right match. He called it his “snakeskin”.
An organ and tissue donor himself, Chelsea found himself in the minority of African Americans. The American medical system has a troubled history of mistreating and undertreating African Americans, which has left many people suspicious of hospitals, doctors, and donor systems.
Dr. Damon Tweedy, an associate professor of psychiatry at the Duke University School of Medicine told TIME magazine that it’s not uncommon for African American patients of his hospital to ask whether they would be “experimented” on or treated like “guinea pigs”. As an African American man himself, Tweedy can personally attest that a mistrust of the medical system can be especially significant in black communities. “There’s some remnant of that that you internalize,” he says of historical and contemporary cases of mistreatment.
So with fewer African Americans being willing to become organ and tissue donors, it makes it harder to find matching skin grafts for people like Chelsea. According to the most recent federal survey on attitudes toward organ donation, only 39% of black Americans’ driver’s licenses marked them as organ donors, compared with almost 65% of white Americans.
“We are a lot more hesitant to be a donor,” Chelsea told TIME. “It causes us to lose out when we need a kidney or a liver or a lung.”
This complex problem presented itself again when Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham Health, approved Chelsea for a face transplant. Chelsea’s first potential match had a much fairer complexion. Chelsea decided to wait.
Face transplant recipients are guided through rigorous psychological preparations before getting their new faces. As most of us could only imagine, waking up one morning to see someone completely new in the mirror has the potential to be a jarring and traumatic experience. Even with the work of transplant psychiatrists, medical teams do their best to match recipients with tissue that’s as close to their own as possible to minimize the risk of negative psychological effects.
In the five years following his car accident, Chelsea had almost grown used to his face as it was. He was used to children staring at him in the grocery stores. He was used to a new, careful way of eating that became necessary without lips. But he missed being able to give his daughter, Ebony, a kiss on the cheek. So in spite of the potential dangers of another major surgery, and in spite of the medication that he would need to take for the rest of his life so his body wouldn’t reject the donated tissue, he decided to stay on the waiting list for a new face.
It took over a year of waiting and searching to find another match for Chelsea. He worked with his medical team to come up with a range of skin shades that they felt would be more natural-looking. While originally, doctors had planned to transplant only the lower half of Chelsea’s face, Chelsea ok’d a full face transplant so that it would be easier to match skin if it was a different shade. They had to expand their search from a conventional 4 hour window.
Finally, in July of 2019, Chelsea got the call. A 62-year-old man with near-identical skin had died suddenly. The man’s brother, James, was approached by the Gift of Life Donor Program, and he quickly agreed to donating his brother’s organs and tissues for those in need, knowing “he would give the shirt off his back for anybody.”
For Chelsea, it was humbling to know that he would be benefitting from the profound generosity of another family. “Losing a loved one and being asked something like this … I can’t imagine,” he said. “I do feel hopeful that I can pick up some of the pieces that the family may have lost.”
Over 45 medical professionals and a 16-hour surgery later, Chelsea emerged from the operating room with a new face. A familiar one.
When Chelsea’s godson, Everick Brown, first saw him, he knew right away “He’s going to be happy”.
Within ten days, Chelsea was breathing on his own, eating and drinking on his own, and talking comfortably. Above all, he felt hopeful for the future. “I was concerned about humanity way before this surgery,” he told TIME. “We must help one another. That’s the way I felt, and this experience has only validated that even more.”
James, the brother of the man whose face was donated, hopes to spread the word about the importance of organ and tissue donation, especially among minority groups in the United States. “I think it’d be a disservice to stay anonymous. Hopefully, this story can put that in a light for others to donate,” he told TIME.
Dr. Damon Tweedy agrees, saying “Sharing can go a long way to healing.”
If you would like to learn more about becoming a donor, or how you can get involved to improve donor numbers, visit https://www.organdonor.gov/awareness.html today.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
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