Doctors in China have grown an entire nose on a man's forehead. But as bizarre as the procedure might sound, plastic surgeons say such transplants are not anything new.
The case in China involved a 22-year-old man from Fuzhou who was involved in a car accident and suffered permanent damage to the cartilage in his nose through infection. Nine months ago, his doctors decided to re-construct a new nose on his forehead.
Dr. Patrick Byrne, the director of facial plastic and reconstructive surgery at Johns Hopkins Medicine, wasn't involved in the procedure, but he says such surgeries are not as odd as they might seem.
"The use of forehead skin to replace missing skin on the nose is actually pretty common; it's something that's been around for a long time and used pretty frequently," Byrne told CTV's Canada AM Thursday from Baltimore.
Normally, it's only skin that's grown this way, using cartilage to form it into the right shape. But in this case, the middle structural area of the nose, as well as the nose lining, were grown on the man's face.
"What's pretty unique about this case is that the surgeons chose to grow all three layers in the forehead prior to transferring the skin to the nose, where it's needed," he said.
Byrne explained that the method allows blood vessels from the skin of the new nose to grow into the cartilage grafts that have been used to create the middle structure of the nose. That should help when it comes time to transplant the nose into its proper position.
"So the main advantage is to make sure the entire structure has a good blood supply prior to stressing it with the move to the face," he said.
Just last year, Byrne himself was involved in a similar surgery, replacing the external ear of a woman with an advanced form of skin cancer. Byrne's team used an ear that was grown in the own woman's arm, using her own skin and blood vessels, as well as cartilage taken from her ribs.
With the man in China, Byrne explained that doctors would likely allow the nose to grow on the man's forehead for several months before they would attempt to transplant it. In order to ensure the structure still had a good blood supply, a component of the nose will remain attached to his forehead for a few weeks – a process that Byrne admits "is a little odd" to see.
"It looks like an elephant's trunk that's connecting the forehead to the nose for a while. And you have to leave that for about a month or so until the blood supply from the face nourishes it enough that you can disconnect it from the forehead," he said.
"So there's multiple steps involved that he still has to go through."
If all goes well, the man should be able to maintain his sense of smell, since the smell receptors are pretty far up the nose, Byrne said.
"I would anticipate that if they can keep the passageway open with this reconstruction, he should be able to breathe normally and he should have a normal sense of smell as well," Byrne said.
