Most people pay little mind to their face until they catch a reflection. Yet doctors see it differently, as breathing lives here. So does smell, voice, flavour, and the act of eating. Recognition begins with it, others know us by it and…we come to know ourselves through it.
Fewer than fifty medical groups across the globe have tried it. Right now in New Delhi, doctors at AIIMS are getting ready. Their goal is not just surgery but giving back an everyday existence, as a new face could mean a return to normal days.
Now launching, AIIMS introduces the nation’s inaugural specialized face transplant initiative, a pivotal moment in healing that may transform lives of those scarred by fire, accidents, attacks with acid, or born with physical differences.
If it works, there won’t be just one more operation added to what Indian surgeons can do. When rebuilding tissue stops being sufficient, this might shift how far medicine can go.
Functional Restoration, Not Cosmetic Surgery
From day one, those working at AIIMS made it known that appearance isn’t the concern here. At a press event, Dr Maneesh Singhal leading the team for plastic, burn, and reconstructive care, described how the procedure targets those left badly scarred by fire, injury, or born with major facial differences, cases where past operations brought almost no improvement.
“In spite of very advanced reconstruction procedures,” he said, “there are patients for whom we are not able to achieve the result they want. For some of them, face transplant may be the only option.”
Appearance isn’t the main aim, Singhal made it super clear. “These patients cannot eat properly, cannot speak, cannot close their eyelids, and live with pain. The aim is to restore function,” he said, as reported by The Print.
Faces matter more than they seem at first glance, and this isn’t about looking better in the mirror. Restoring function drives the procedure, as when trauma steals normal life, doctors try to give it back.
What Happens During The Procedure?
A face transplant ranks as one of today’s toughest surgical challenges. From someone declared brain dead, doctors take skin, blood vessels, nerves, occasionally bone and move these tissues to another person. Though rare, the operation requires precision across multiple systems at once. Success hinges on careful matching plus timing down to the hour.
The surgery can include replacement of:
- Facial skin
- Eyelids
- Lips
- Nasal structures
- Arteries and veins
- Muscles required for facial movement
- Sensory nerves
In some cases, even the bone that supports facial features.
This isn’t like swapping out just one kind of tissue. Instead, doctors group it under vascularised composite allotransplantation, where several kinds move together as a working whole.
Most crucially though, surgeons at AIIMS stress that what people receive isn’t some fresh face handed over like a gift. “In most cases, donor tissues are grafted onto the patient’s existing bone structure,” Dr Singhal said, “so the final appearance does not change significantly.”
Restoring basic functions comes first; eating, moving food down the throat, using words, catching scents, closing eyes, and feeling touches on the face. Getting these actions working again through gradual rebuilding is the center of this transplant process.
Face Reconstruction Compared With Face Transplant
Faces take shape again at AIIMS, often helping those harmed by acid attacks. Yet what sets transplant apart runs deeper than repair alone. Flesh from a person’s leg, shoulder, or upper body often becomes part of fixing injured face areas. Step by step, through several operations, doctors reshape what was lost. A different chunk of the body gives material each time. The process unfolds slowly, and it is never rushed into one go.
A fresh face can come from another person when regular fixes just do not work anymore, especially after many tries that did not help. This kind of surgery swaps out big areas of hurt skin and structure all at once, using someone else’s healthy parts instead.
A Procedure Done Just About 50 Times Worldwide
Fifty people worldwide now live with new faces, most of them helped by surgeries across America. A few cases turned up in Turkey, then later in China. Across Asia, it’s shown up more than once. A first for India, this effort marks new ground, none of the nation’s hospitals have launched a complete face transplant service so far, according to staff at AIIMS.
Thinking about what makes this surgery super duper rare? Behind each one lies a web of support, years of follow-up, and complex logistics holding it together, so no, it is not just about how hard the surgery is.
Matching Donors and Following Patients Over Time
Finding donors who fit can be one of the toughest steps.
“But it is not easy to find a suitable donor,” Dr Singhal told ThePrint. “Matching goes beyond blood group and tissue compatibility. It also requires skin colour match,” he said, as reported by The Print.
A single second can change everything when it comes to face transplants. No substitute exists once a match isn’t found fast enough and brain-dead donors are the only source possible. Without one ready at the right moment, the chance vanishes completely.
“A harvested face skin only survives for two hours,” Singhal said, he said, as reported by The Print.
Much depends on timing, similar to how a heart or liver transplant demands exact alignment.
The Lifelong Weight of Taking Immunosuppressive Drugs
Most folks think it happens just once, but face transplants demand ongoing care, much like those who get hearts or kidneys, people must take immune-dampening drugs forever after.
When Dr Indranil Sinha stopped by AIIMS, thoughts on rejection painted a grim yet clear picture. He holds a top post in plastic surgery at Brigham and Women’s Hospital, tied to Harvard Medical School. That worry didn’t fade during his visit, as rejection still stands firm as a key issue.
“Some people reject at one month, three months, six months. We monitor them closely,” he said.
Right off the bat, Dr Dipankar Bawmick, professor and head of nephrology at AIIMS, pointed out how routine the anti-rejection protocol feels there. Though new to some, it’s something they’ve handled many times before. For him, it’s just another day navigating known paths in treatment.
“The anti-rejection drugs are the same. We use a triple-drug regimen – steroid, tacrolimus and mycophenolate,” he said, as reported by The Print.
Fewer safeguards mean higher chances of illness or harm to kidneys, so checks must keep happening without pause.
Doctors at AIIMS explain that several specialists must work together for the operation
- Anaesthesiologists to keep the patient stable during long hours
- ENT specialists to manage airway-linked facial structures
- Scientists who study immunity work to stop the body from rejecting transplants
- Pathologists to ensure tissues are healthy
- Organ retrieval teams to preserve facial tissue within a limited window
Last thing on everyone’s mind at AIIMS? Getting that permit from the state transplant board, which is still pending. Even after months of meetings across departments, paperwork hasn’t moved forward yet, talk started early, but steps came slowly post that. Internal chats continued, yet no formal request was filed.
“We would aim to register at least 10 to 20 potential recipients over the next six months and will soon get a licence,” Dr Singhal said, as reported by The Print.
A New Era of Healing in India
A human face given anew, this is what AIIMS Delhi now offers through its transplant initiative. When eating, speaking, or blinking hurts too much, appearance isn’t what the world should be discussing. Instead, relief becomes the quiet goal behind every step taken. If AIIMS pulls this off, India might join a rare group of countries able to offer more than just rebuilt faces, they could return full lives to patients.