Transfiguration: New Yorker examines life of face transplant recipient Dallas Wiens

By Liz Kowalczyk, Globe Staff

Unflappable seems a good way to describe Dr. Bohdan Pomahac, the bold young surgeon who has successfully completed four face transplants at Brigham and Women’s Hospital, often embracing especially risky patients.

But in a New Yorker magazine profile this week of Dallas Wiens, one of Pomahac’s patients, the surgeon reveals that the unparalleled time pressure involved in removing the face from Wiens’s donor was almost unbearable -- and something he’s unlikely to attempt again.

The absorbing piece by Raffi Khatchadourian delves into Wiens’s troubled past and the power line accident in Texas that burned most of his face down to the bone. It also describes how little time Pomahac and Dr. Elof Eriksson had to retrieve the donor’s face. Normally the doctors require about six hours to dissect the nerves and blood vessels and prepare the face for transport to the Brigham. But transplant surgeons from another unnamed hospital needed the donor’s liver for a very sick patient -- a life-saving operation that takes precedence.

Pomahac negotiated three hours from the other surgeons, who then moved in to stop the donor’s heart and begin removing the liver. The New Yorker reported:

Without blood, the facial tissue would survive for no more than four hours. ‘The clock started ticking,’’ Pomahac said. He and Eriksson had dissected about two-thirds of the face. ‘‘We tried as fast as we could to finish.’’ ... “At one point, I was wondering, am I crazy?” ... ‘‘Is it even worth it, to put myself in such a situation? I could have had a heart attack.”

When I asked Pomahac today about the operation, which took place last spring and was the Brigham’s first full face transplant, he said the situation “was very unhealthy. I think it cut out 10 years of my life.’’ Of course, he is pleased that in the end, the transplant turned out well for Wiens, who lives with his grandparents in Texas. But until the operation becomes more routine, he said he won’t try to remove a face again with that little margin for error.

For a detailed account of how Pomahac convinced the Brigham to allow controversial face transplants, go here.

Liz Kowalczyk can be reached at kowalczyk@globe.com.