But despite the hours of meticulous work, Maki, a disabled Vietnam veteran who grew up in Amherst, still did not have a nose and his speech was barely understandable. Conventional surgery had limits, and Pomahac was frustrated he couldn’t do more.
Then, in February 2006, French surgeons unveiled the world’s first face transplant patient, Isabelle Dinoire, who had been mauled by her dog. Pomahac stared in disbelief when he saw the before and after pictures of Dinoire on the Internet. She looked so normal. She had a nose. She had lips.
I could operate on that woman 100 times and never get close to those results, he thought.
Pomahac knew what he wanted to do: Give disfigured patients new faces. Give them entirely new lives.
It was an audacious idea for such a young, unproven junior surgeon. Pomahac would have to coax a cautious Harvard teaching hospital to embrace an almost fantastical new procedure, one that was the focus of international controversy.
He needed millions of dollars to pay for the surgeries and to assemble a team of dozens of doctors and nurses. He had to persuade the region’s organ donor agency that families would consider the unthinkable, donating the face of a loved one to a stranger. And perhaps most daunting, Pomahac would have to nudge his way into the elite community of established New England transplant surgeons, who were afraid that lifesaving donated livers, kidneys, hearts, and lungs would be rendered unusable if there was a delay to remove donors’ faces, for a procedure that at the time many considered cosmetic.
It took more than two years, but in May 2008, the hospital’s ethics board approved a face transplant for Maki. Since then, the Brigham has done a total of four, surpassing the Cleveland Clinic as the leading program in the United States and becoming the second busiest center in the world after a French team.
