Worth the wait: Dr. Borsuk leads surgical team in Canada’s first facial transplant

March 8, 2019 | Author: Royal College Staff

It made headlines across the country: the first face transplant in Canada. It took five years to plan, 30 hours to complete and the participation of more than 100 people.

Although this procedure — a vascularized composite allotransplant — is over a decade old, it remains uncommon and relatively new in the field of transplantation. It’s only been done about 40 times in the last 13 years, in large part due to the complexities inherent to this kind of procedure. The few teams in the world who perform this surgery are all in contact, eager to learn from one another and to make the surgery safer and maximize the benefits to the patient.

Dr. Daniel Borsuk, MD, FRCSC, a plastic surgeon at the Maisonneuve-Rosemont in Montreal, led the team of nine surgeons who performed this Canadian first. He emphasized that extensive planning was the cornerstone of their success.

“There was a plan B, C, D, E, F and G,” he said with a laugh.

“We weren’t going ahead saying, ‘well, if it doesn’t work, it doesn’t work’; there were a lot of contingency plans, but the idea being that we have to plan for [the transplant] as if there is no plan B. We have to train and prepare every type of scenario possible and prepare for every possible eventuality. Basically our plan – which encompassed a lot of contingency plans – had to work.”

Dr. Daniel Borsuk

Dr. Daniel Borsuk

Dr. Borsuk trained in Baltimore at Johns Hopkins and the University of Maryland Shock Trauma Unit. In 2012, he assisted on a 36-hour facial transplant. At the time, it was the most extensive transplant of its kind ever performed. When he returned to Canada that same year, he felt strongly that Canadians should also have access to new forms of transplantation like upper extremity and facial.

Dr. Bosuk spent years building his team in Montreal and working with Transplant Quebec to find and gain consent for a donor who matched the patient’s skin colour, bone proportions and many other physical parameters. Emphasizing the need, patient benefits and new research possibilities stemming from this form of surgery, he earned support at the federal, provincial and local levels.

 “It’s one thing to do a face transplant. It’s another to have one that is beautiful and one that achieves all of our goals of restoring aesthetics and function. It took five years, but I think we finally got that plan to be as close as possible to perfect for that transplant.”

Dr. Borsuk confirmed that more patients are currently being evaluated for a facial transplant.

Transplant recipient, Mr. Maurice Desjardins, before and after surgery – front and side views (photos courtesy of Dr. Daniel Borsuk)

Transplant recipient, Mr. Maurice Desjardins, before and after surgery – front and side views (photos courtesy of Dr. Daniel Borsuk)

Read more about this pioneering surgery