FORT WORTH, Texas (BP)–Dallas Wiens bears little of his former image — at least not above the shoulders. But by all accounts, the image of God in him shines brighter than before. Soon, with the help of leading-edge medical science, a new face will adorn the 25-year-old burn victim.
Wiens learned in October that he is in line to become only the third person in the United States to undergo a facial transplant surgery to radically transform his marred physical image and give him cosmetic advantages unthinkable only a few years ago.
The two previous such transplants — first at the Cleveland Clinic in 2008 and at Brigham and Women’s Hospital in Boston last year — were partial facial transplants. His would be the first full facial transplant in the United States and only the third worldwide.
A facial transplant is needed when reconstructive facial surgery has not been satisfactory. Reconstruction uses skin and tissue grafts taken from another part of the patient’s own body and usually results in serious scarring and many operations.
Facial transplantation includes the transfer of soft tissues, with or without facial bone, from a deceased human donor to a patient with severe facial deformity. The survival of the transferred tissues depends on the reestablishment of blood circulation. Using a microscope, surgeons connect blood vessels of the facial transplant to vessels on the recipient; nerves also are connected to allow for the return of sensation and motility to the face.
Wiens’ contact with a high-voltage electrical line while painting a church in November 2008 should have killed him. It left him blind and badly disfigured, but lucid and remarkably functional.
If a suitable facial donor is identified, Wiens would fly to Boston within hours to undergo the rare procedure at Brigham and Women’s Hospital followed by weeks and months of post-operative care in Boston and at Parkland Memorial Hospital in Dallas.
In a joint statement released by both hospitals Oct. 13, Wiens announced the news he’d been waiting for: He was officially on the transplant list with the New England Organ Bank.
News coverage of Wiens’ case has focused on the breakthrough medical techniques that might seem more fitting for a futuristic novel than real-life medicine. But his press statement went deeper.
“My faith in Christ has driven me through the trials that I have faced. It has not been in my own strength that I have come to the point that I am today. I firmly believe that He will see me through anything that is to come. There is no reason to allow a few hurdles to keep me from finishing ‘The Race.'”
BEATING THE ODDS
On Nov. 13, 2008, Wiens, his oldest brother and an uncle were finishing a painting job at the church he attended as a boy, Ridglea Baptist in Fort Worth, just a few blocks from the house he’d grown up in, when the cherry picker Wiens was painting from made contact with a high-voltage power line.
Rushed by helicopter 35 miles to Parkland’s world-renowned burn center, surgeons spent a grueling 36 hours over two days working to save Wiens’ life and his devastated facial structure. It was the worst burn case Parkland had seen in 30 years, doctors told the family.
Forty-eight hours later, doctors gave the family slim hope, his grandmother, Sue Peterson, said. Hours passed, then days and weeks. Bracing for the worst, doctors told the family that Wiens likely would be paralyzed from the neck down and would never speak or produce enough saliva to eat solid food.
Not only did Wiens survive, but once he awoke from a medically induced coma three months after the accident, he made unprecedented progress.
Wiens left the hospital in spring 2009, placed his wheelchair in a storage shed that June, and today is walking six blocks at a time with a cane to help him locate landmarks in his Fort Worth neighborhood, where he lives with his grandparents.
He’s up to 27 push-ups and is a regular at Starbucks, where a cap and sunglasses partly mask his disfigurement. He’s also taking college classes online, studying Scripture with audio and online Bible software, and following his beloved Oklahoma Sooners football team with his ears and his mind’s eye.
But most significant to Wiens are the spiritual blessings gained at the expense of his eyesight, his face as he knew it, and the sensation of a hug or kiss from his 3-year-old daughter Scarlette.
“When you can’t feel your daughter’s kisses, that’s hard,” Wiens said.
Formerly far from God, in his words, the accident took him to the edge of eternity and back. Wiens repented before the Christ he was taught about and professed as a child. He also joined Ridglea Baptist Church, where his grandparents are members, and has weekly sessions with his pastor to discuss faith and other topics.
“In the midst of my despising God, He was right behind me, preparing me to do His work,” Wiens said.
For now, Wiens’ face is draped in skin and muscles painstakingly transplanted from his calf, thigh and back. These muscle flaps, as they are called, provided surgeons the ability to restore some structure and skin to his face. Also, his speech is remarkably clear relative to his injuries.
With the facial transplant, surgeons are confident Wiens will have most of the sensation and functionality restored to his face, though he would remain blind. One eye was completely devastated; the other remains intact and the ocular nerve is “alive,” but Wiens said technology to restore sight in that eye is years away.
Doctors have told him there is no chance he will look like the donor and there is better than a 60 percent chance they can reconstruct some recognizable features of his former face.
According to information provided by Brigham and Women’s Hospital, there are some critical parameters that must be met in order to improve the likelihood of success of a facial transplant:
— Age is a factor, and the donor cannot be more than 10 years older or more than 20 years younger than the recipient.
— Skin color and texture must be similar between the donor and recipient, and their blood types must match.
— The donor must be within a four-hour travel radius of the performing hospital; the recipient must be able to arrive within 12 hours of being notified.
His surgery in Boston at the hands of Bohdan Pomahac, a plastic surgeon at Brigham and Women’s Hospital and director of its burn center, and subsequent care while there will involve a transplant team of more than three dozen clinicians, including eight surgeons, as well as other doctors and nurses from multiple disciplines, from cardiology to infectious disease, Pomahac said.
His recovery in Boston will take weeks, followed by months of post-operative care at the hands of Jeffrey Janis, chief of plastic surgery at Parkland who has cared for him since the accident and the Dallas hospital’s team of specialists.
Wiens eventually will get dental implants and prosthetic eyes as well.
He will require about $2,000 a month in immunosuppressant drugs for the foreseeable future, something his health coverage will pay for. The surgery itself is paid for by a Defense Department grant and is part of a case study to benefit disfigured and burned service members — something Wiens, an Army veteran, is excited about.
“It’s not all about me and my story. I’m paving the way for others,” he said.
Wiens said he learned of his placement on the waiting list several days prior to the public announcement and is ready to travel to Boston with his grandfather, Del Peterson, when the phone call comes.
American Airlines flew Wiens to Boston for his last visit during the evaluation process and has agreed to fly Wiens there again on the first available flight from Dallas.
“I cannot begin to express my gratitude to the teams at Parkland Memorial Hospital that have brought me thus far,” he said in the statement announcing his placement on the waiting list. “I have been making medical history from day one and as several chapters have been closed new ones are being written. I am glad to step into this newest chapter with faith and hope.
“I am supremely confident in the skills of each member of the facial transplant team at Brigham. Their desire to push the envelope is matched by my own. I am staring down the beginning of a brand new life; as far as I can see, this new life is full of hope and joy and that is how I fully intend to face it.”
Jerry Pierce is managing editor of the Southern Baptist TEXAN, newsjournal of the Southern Baptists of Texas Convention, on the Web at texanonline.net. A short video featuring Wiens is accessible at youtube.com/sbtcweb or youtube.com/watch?v=EpO03xsEwhc/. Dallas Wiens has established a fund to offset costs not covered by insurance and to help future burn victims with medical care: “Dallas About Face Fund,” c/o Ridglea Baptist Church, 6037 Calmont Ave., Fort Worth, TX 76116.