A man who suffered a serious accident while hunting was living with what was left of a badly disfigured face. A bullet had blown away much of his face in 2011. Several rebuilding surgeries over the years had helped but left him breathing through a hole in his windpipe, a mouth that couldn’t close, and years of constant pain. Then Maurice D. of Gatineau consulted wth Dr Daniel Borsuk in Montreal, who at age 40 was a young but already renowned plastic surgeon. A bold plan was discussed, something done barely a few times ever in the world, that of a face transplant. Operation in May, success revealed now Dr Borsuk explained the severe risks, that Desjardins could die on the operating table, that he cold die from the body’s rejection of the face, or from cancer as a result of anti-rejection drugs he would have to take for the rest of his life. Desjardins response was to go ahead, saying “what kind of life do I have now?” Four years in the planning, a donor was found, That too is a challenge, as the donor must be brain dead, but the heart still working in order keep facial tissue, and muscle alive. Once removed, the tissues have only a couple of hours before they must begin receiving blood again, or be lost. Leading a medical team of 9 surgeons, 15 specialists, and dozens of other medical staff in an operation that lasted 30 hours, the complete face of the donor, and what remained of the patient’s face, were removed and the new “face” was placed on the patient, where blood vessels, skin, nerves, bones, cartilage and teeth were attached to the patient. Although the transplant took place in March, it is only now being made public as the extremely complex, rare, and risky operation has been deemed a success. Another issue is a psychological one as Desjardins has to get used to seeing a new face in the mirror that he cannot recognize as being him. Additional information- sources<doc-sep>Calgary Herald Headline News Sign up to receive daily headline news from the Calgary Herald, a division of Postmedia Network Inc. Email Address There was an error, please provide a valid email address. By clicking on the sign up button you consent to receive the above newsletter from Postmedia Network Inc. You may unsubscribe any time by clicking on the unsubscribe link at the bottom of our emails. Postmedia Network Inc. | 365 Bloor Street East, Toronto, Ontario, M4W 3L4 | 416-383-2300 Thanks for signing up! A welcome email is on its way. If you don't see it please check your junk folder. The next issue of Calgary Herald Headline News will soon be in your inbox. We encountered an issue signing you up. Please try again<doc-sep>Share this Story: Canada's first face transplant Canada's first face transplant 'It snapped into place perfectly, like a puzzle piece' Article content MONTREAL — It took 12 hours to remove the face, four surgeons working from morning into the night, cutting through skin, muscle, blood vessels, nerves and bones, until it was lifted from the man’s skull. It was a beautiful face. The flesh smooth and plump, the mouth and lips generous and full. It was still attached by two arteries and three veins to the donor’s neck. His heart was still beating strong, his body warm to the touch. His skin flushed pink with blood. We apologize, but this video has failed to load. tap here to see other videos from our team. Try refreshing your browser, or Canada's first face transplant Back to video Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content We apologize, but this video has failed to load. tap here to see other videos from our team. Try refreshing your browser, or But when the surgeons cut and clamped the last five vessels, freeing the face entirely from the brain-dead organ donor’s body, it instantly began to turn white as his life drained from it. Dr. Daniel Borsuk cradled the face in his cupped palms, carefully washed away the blood and injected the arteries and veins with a preservation fluid. Without a blood supply it would survive only two to three hours. In the next room, Maurice Desjardins was almost ready. His old face, the mutilated one, was gone, disassembled over 17 hours by a second team of surgeons. Only his eyes, upper eyelids and forehead remained. Seven years ago, a bullet from a hunting rifle destroyed Desjardins’ nose, lips, teeth and upper and lower jaws. Surgeons had tried rebuilding his shattered face over the years, using plates and screws and bone chiselled from his fibula. But he was still left with two holes where his nose used to be and a mangled and puckered mouth that he couldn’t close, which meant he couldn’t eat properly and drooled constantly. He breathed through a hole in his windpipe. He was in chronic pain from the rigid scar tissue and the loose, disconnected nerves floating in his skin. Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content On the rare occasions Desjardins left his rural home outside Gatineau, Que., he wore surgical masks. He lost his roofing business. He had lost his former self by the time he was sent to Borsuk, a plastic surgeon in Montreal adoring patients refer to as “un magicien du visage.” The doctor told him he had only one real option left, something never before attempted in Canada: A face transplant. The stakes were incredibly high. There was a chance Desjardin could die from blood loss on the operating room table, or from his body’s rejection of the new face afterwards. There was a significant chance he could end up with a lethal cancer because of the drugs he would need to take for the rest of his life to keep his body from rejecting another man’s face. But it was a possibility, a coin toss — an opportunity at a second chance in life. When Borsuk informed Desjardins and his wife that he was willing to try, if they were, the couple wept. Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content It took five years of planning, nine surgeons, five anaesthesiologists and more than 100 other medical, nursing, support and technical staff. But when Borsuk finally carried the donor’s face to that second operating room and placed it over Desjardins’ skull, it snapped into place perfectly, like a puzzle piece. *** Desperate people find Borsuk. At 40, the Montreal native is a skilled surgeon known by his older mentors as a boy wonder. He’s a perfectionist, with zero tolerance for incompetence, but a leader who can bring people together and make magical things happen. Borsuk has always been drawn to the face — its beauty, its structure, “the whole window-to-the-soul thing.” The way it’s tied to our identity, our personality. His own face is handsome, his stubble beard neatly trimmed, that perfect, signature 5 o’clock shadow look. Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content Borsuk experienced an almost religious calling to plastic surgery. He was a first year MBA student at McGill University when Dr. Chen Lee, the then newly appointed head of plastic surgery, called the business school for help. Lee was looking for volunteers to help find the delays, the bottlenecks to rapid care for people who needed accidentally amputated body parts reattached. One day Lee called Borsuk. “Dan, come to the operating room,’” he told him. A 14-year-old had amputated his arm in a wood chipper. Lee wanted the young business student to see what microsurgical replant surgery could do. Borsuk arrived at the Montreal General in his suit and tie. He was taken into the operating room, “and there’s an arm and a kid and it’s the most incredible thing. I was standing there in shock. I didn’t realize you could literally attach an arm and the nerves and the tendons. It was so complex and wild. It was like Star Wars.” Advertisement Story continues below This advertisement has not loaded yet, but your article continues below. Article content “This is what I want to do,” he thought. “I want to do this.” What he does today are heavy, complex cases — children born with neurofibromatosis, or so-called “elephant man” disease, kids and adults with malformed jaws, orbits and skulls. Children with cancers or burns, or lips and cheeks sheered off by pit bulls. Adults with faces pulverized by bullets. One of those faces belonged to Richard Norris, who, in March 2012, underwent what was then the most extensive human face transplant ever at the University of Maryland.<doc-sep>For Dr. Daniel Borsuk it all came down to that moment. “It was the most spiritual experience for everyone who was there. When it finally happened, when he finally looked in the mirror it hit home. Everyone in the room, the security guards, we were all crying.” Dr. Borsuk a well-known Canadian plastic surgeon has now found his place on the world stage. Heading up a team of more than a hundred doctors, surgeons, nurses and medical professionals at Montreal’s Maissonneuve-Rosemont Hospital, to perform Canada’s first ever face transplant. “It’s a surreal experience just to see how everyone got together to give this result.” The long journey had a tragic start in 2011. That’s when Gatineau man Maurice Desjardins, now 64, suffered a devastating gunshot wound to his face. The bullet, from a hunting rifle, destroyed Desjardins’ upper jaw, lower jaw, nose and lips. He lost his ability to speak properly and his ability to eat and drink, “and more importantly,” Dr. Borsuk says, “he lost his ability to walk in public without the looks of others.” Dr. Borsuk starting treating Desjardins five-years ago, working on a precise and careful plan to one day transform Desjardins life. “He wanted to breathe properly and speak properly. He wanted a nose, lips, jaws and teeth,” Dr. Borsuk told a news conference on Wednesday, “if he’s going to be the first in the country he’s got to be the perfect patient.” So the medical team spent two years carefully evaluating Desjardins. Psychiatric and medical tests and treatments to ensure he could physically and mentally handle the life changing surgery. And then one day last May, Dr. Borsuk got the call; a man on life support had all the necessary traits to be a donor. “A perfect colour match, not almost, a perfect hair match and a perfect match of the bones of the face.” The team assembled. In all there were nine surgeons, six anesthesiologists and hundreds of medical staff together to perform the Canadian first surgery. There were even security agents guarding Desjardins to protect him from unwanted eyes. The surgery would last a grueling 30 hours as the team of surgeons reconnected bones, arteries, veins, nerves, skin and muscle. Then came the moment Maurice Desjardins had been waiting for, to look in the mirror and see himself for the first time. “As he looks in the mirror for the first time,” Dr. Borsuk recalls, “it’s like a child looking in the mirror for the first time, touching their nose, their face, it’s disbelief, like ‘I can’t believe this is possible’.” Four months later, Dr. Borsuk says Desjardins is recovering better than expected, “he’s learning to eat again, he’s learning to speak, he’s learning to smile, already at four-months he’s doing better than the average face transplant (recipient).” While Dr. Borsuk and his team performed the miracle, he says it’s the anonymous donor and his family who are the real heroes, “it’s the greatest gift you can give in your life to help someone else live a more normal and a longer life.” Desjardins journey ahead will be long, doctors monitoring him for symptoms of transplant rejection. Dr. Borsuk says already though, Desjardins not only has a new lease on life, but a new sense of acceptance, “already he’s leading more of a normal life. He’s able to walk around, nobody looks at him. They used to always stare at him, now he’s just another face in the crowd.”<doc-sep>
MONTREAL -- In a Canadian medical first, surgeons at Montreal's Maisonneuve-Rosemont hospital announced Wednesday they'd performed a face transplant, giving a badly disfigured Quebec man a second lease on life. Hospital officials detailed last May's complex and risky 30-hour procedure involving Maurice Desjardins, who at 64 was described as the world's oldest recipient of such a transplant. A team led by plastic surgeon Dr. Daniel Borsuk was part of the first Canadian attempt at the surgery, which has been performed about 40 times worldwide since 2005. Borsuk said there was no other option for Desjardins, who'd been living in constant pain and isolation despite five reconstructive surgeries since a hunting accident in 2011 left him without his jaw, nose and teeth. "Imagine when you're suffering in silence at home for years and you don't leave your house as much as you'd like to, and you're sleeping in a separate room because of the sound of the tracheostomy (opening in the trachea)," said Borsuk, who also teaches at Universite de Montreal. "You're living this very difficult existence. Then, overnight essentially, you get a second lease on life." Desjardins came to see Borsuk in Montreal with a few requests: to be able to breathe properly, speak properly and to have a nose, lips, jaws and teeth. Borsuk said Desjardins also wanted to be able to walk outside with his granddaughter without people staring at his disfigurement. The patient was carefully vetted for years before the procedure. "We put him through the wringer in terms of tests," Borsuk said. "We wanted to make sure this guy was in good health ... his needs were there, there was no other option for him, and there was no other chance of him having a normal life." Borsuk said the experts involved in Desjardins' case included a psychologist who evaluated his mental fortitude over many years. "He's so mentally tough that even with everything that was done, he's already begun (accepting) the new face," Borsuk said. "That's something we were counting on." Borsuk described the procedure as "a combination of science, technology, engineering and art" that required years of planning in training in the cadaver lab in the bowels of the hospital to minimize risks and maximize results. The Quebec operation required the expertise of nine surgeons, multiple specialists and the collaboration of more than 100 professionals, including doctors, nurses and many other personnel. After seven-and-a-half years of living with his disfigurement, 30 hours of surgery and one week in intensive care, a shocked Desjardins took a look at his new face for the first time and gave Borsuk a thumbs-up and a hug. "You can make a face, but it has to be beautiful," said Borsuk, who believes the team accomplished "one of the best face transplants to date." Transplant Quebec, the province's organ procurement organization, highlighted the generosity of the unidentified donor's family, which granted permission for the procedure. Borsuk said it couldn't be just any donor, but one who had the same skin colour, height, bone structure and even hair colour -- so that even the sideburns and beard of the transplanted face matched Desjardins' own hair colour. Louis Beaulieu of Transplant Quebec said the donor was identified and special consent obtained for the facial transplant procedure, which was done in an ethical and respectful way given the donor's family was dealing with a recent death. "The process from the identification to procurement is around 40 to 48 hours, that's the window we are working with," Beaulieu said. Neither Desjardins nor his wife were present Wednesday, but Borsuk reported the patient is recovering well and able to breathe without a tracheostomy, chew with his new jaws and also smell and speak properly. Recovery and rehabilitation will take a year or more as he relearns basic skills like eating, drinking and even smiling. He will be on immunosuppressant drugs for the rest of his life. As for the ethics of transplanting another human's face, Borsuk said he didn't view it as different from any other transplant, adding the face has taken on an added importance thanks to social media. Underneath the transplanted face was the same Maurice Desjardins, he reminded reporters. "It used to be in the time of our grandparents, that your name meant something," Borsuk said. "Now people want to see your face."