After Dallas Wiens was horribly burned by a high-voltage electrical line, he was unconscious for three months before finally waking up and feeling his face. "I had no features at all," he said, "I cried when I first got home."
As the nation's first recipient of a full face transplant, Wiens awoke after surgery in March at Brigham and Women's Hospital and immediately asked a nurse if it was okay to touch his face.
"I started at the edge and worked my way in," said Wiens, who is blind from the 2008 accident. "I had a nose, I had eyelids, and I had lips. I was amazed."
In a 15-hour surgery with 30 specialists, Wiens received a new face from his mid-scalp to his neck. He has been living temporarily in a furnished apartment two blocks from the Brigham with his grandfather, Del Peterson. In his first newspaper interview after the surgery, Wiens said last week that he is healing well, but he has lost significant weight and is eager to return home to Fort Worth, Texas.
The nation's second full face transplant recipient, Mitch Hunter, is living down the hall from Wiens, and the two men have spent many hours comparing notes on their medications, plans, and children.
Wiens is impressed by how his new face, from an anonymous donor, is gradually becoming part of him. Wiens was very lucky to find a match, doctors said, because previous skin grafts he had using donor tissue primed his immune system, making it more likely it would reject subsequent donor tissue.
A thin scar, like elastic string on a party hat, runs from in front of his ears and under his chin, but it is only noticeable close up. At first, the donor's hair at the front of his scalp felt very coarse to him, which Wiens, who turned 26 on Friday, wasn't happy about. But now it feels more like his own. He has feeling in his left cheek. As more donated nerves meld with his own, he will be able to smile.
"It's science fiction realized," said Lory Moore, a friend and advocate who flew in to visit Wiens last week. "It's just beyond comprehension what these brilliant doctors can do."
A crucial moment came last Tuesday, when Wiens' 4-year-old daughter, Scarlette, arrived in Boston and saw his new face for the first time. He had to say her name twice, before she recognized his voice and ran over to him and asked him to pick her up. "I started crying," he said. Later, Scarlette commented that he was "so handsome."
Wiens was deeply burned when a cherry picker he was standing in to paint a church brushed against a power line. Doctors had to remove most of his facial muscles, tissue, and nerves, essentially leaving just his skull in front, which surgeons in Texas covered with muscle and skin from his back.
The American Academy of Plastic Surgeons voted Wiens The Greatest Save of 2009.
When he woke up at Parkland Memorial Hospital in Dallas, Wiens kept asking to see his daughter, who was then 18 months old. Staff were hesitant because they had never introduced a child under 5 to a disfigured parent, he said. But they did so gradually, at first showing him sleeping, his arms folded on his chest. "She said, 'Those are my daddy's hands'," Wiens recounted.
Unlike James Maki, who was a near recluse before receiving a partial face transplant at the Brigham in 2009, Wiens went to restaurants and friends' homes and became a regular at a local Starbucks in the months following his injury. "I have very, very good friends who said, 'No, you're getting up and going out,' " he said. Many are friends he made at Parkland during his 22 surgeries.
Strangers' stares didn't bother him. "I could wear my sunglasses and hat and disappear," he said. "Because I couldn't see anyone, I thought they couldn't see me."
Wiens only refused to attend Scarlette's dance recitals and other preschool activities, not wanting her to be the subject of ridicule. The thought of missing out on those events throughout her life is what led him to decide on the face transplant.
Wiens now takes antirejection medication three times a day, to keep his immune system from attacking the donor tissue. So far, he has not had an episode of rejection, but lead face transplant surgeon Dr. Bohdan Pomahac likes the patients to live near the hospital for two to three months in case they need to be treated for the problem.
Last Thursday morning, Wiens ate plain pancakes and drank water before taking his pills -- he lost his teeth in the accident and hopes to eventually get implants.
He said he also will have surgery to remove excess tissue under his chin, and to repair a slight droop around the right side of his lip.
Wiens is largely apartment-bound, except for his twice-weekly check-ups at the Brigham, partly because his grandfather is anxious about him navigating Boston sidewalks.
"I want to get back in my own space with my own family," Wiens said. "That will be therapeutic."
About white coat notes
|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at firstname.lastname@example.org. Follow her on Twitter: @cconaboy.|
Gideon Gil, Health and Science Editor
Elizabeth Comeau, Senior Health Producer