— For the past two years, Charla Nash has veiled her face to cover the damage from a vicious attack by her friend’s pet chimpanzee that left the Connecticut mom blind in both eyes and without a nose, ears or lips. The chimp also tore off both of Charla’s hands.
Now, thanks to a ground-breaking transplant surgery, Charla has gotten a new face. In a grueling, 20-hour operation, a 30-member surgical team under the leadership of Dr. Bohdan Pomahac at Brigham and Women's Hospital performed a full face and double hand transplant.
When the surgery was over, Charla’s brother and daughter Briana went to visit her in recovery and saw her new face for the first time.
“She looks fantastic,” Briana told TODAY’s Ann Curry in an exclusive interview. “You’d never believe something like that could be done. She looks just like everyone else. It was so good to see she can have an experience just like everyone else. I’m just so excited for her to learn to use it and let it become part of her life.”
Because doctors transplanted not only a face, but also two hands at the same time, Charla’s surgery last month was a medical first in the United States. Unfortunately the hands failed to thrive as she struggled with pneumonia which led to low blood flow to her new hands. They were removed.
But overall, her recovery and future look excellent. Her doctors say they can try again when new donor hands become available.
“Transplanting a face and hands together is basically an unparalleled quest,” Pomahac, Charla’s lead surgeon, told Curry. “The complexity, logistically and surgically, I think makes it the most challenging thing we can do these days.”
Pomahac described the surgery to Curry:
“We took tissues from the donor that included the skin and underlying muscle of the entire face,” he said. “But we also took the nerves that power it and provide sensation. And the upper palate. And the whole unit was transplanted on Charla.”
Pomahac predicts that the donated tissue will eventually conform to Charla’s underlying bone structure, allowing her look something like she did before the attack.
“From what we know, she will not resemble the donor,” Pomahac told Curry. “She will be looking like someone a little different than she was before the accident, but different than the donor.”
The name of the donor was not disclosed to maintain her family's privacy.
The donor can be as much as 20 years younger or up to 10 years older than the recipient and must have the same blood type and similar skin color and texture.
Experts not connected with the Boston case said it was medically riskier than previous transplants, but not unethical.
"Hand transplants and face transplants are big operations. When you combine the two big operations, it can be a challenge," said Dr. Joseph Losee of the University of Pittsburgh, which has done three double and two single hand transplants and is preparing to offer face transplants soon.
Dr. Warren Breidenbach, who led the nation's first hand transplant, in 1999, at Jewish Hospital and the University of Louisville, said:
"It is completely ethical, and the proper thing to do, to do the face and the hands at the same time."
Doing them separately, or attempting another hand transplant for Nash in the future, raises the risk of rejection because tissue from two different donors would be involved, said Breidenbach, who is now chief of reconstructive and plastic surgery at the University of Arizona.
Nash's was the third full face transplant in the U.S.
Charla was visiting her friend, Sandra Herold, in 2009, when Herold’s chimp went berserk and attacked. Doctors were able to save Charla’s life, but she’s been in an assisted-living facility ever since being released from the hospital, unable to eat solid food and still breathing through a tube.
Charla and her family had hoped that the transplant operation would allow her to return home and lead a more normal life. “Getting my face and hands together, that would be nice,” she told TODAY before the surgery. “Being able to do everything on my own, wash myself and stuff with my own hands.”
Over the next several months she will develop more control over facial muscles and more feeling, letting her breathe through her nose and develop her sense of smell. She remains blind.
High on Charla’s list was being able to do things most of us take for granted. “I want be able to eat on my own,” she said. “I want to be able to hold a cheeseburger or a hot dog in my hand and put it in my own mouth and eat.”
For her part, Briana can already see parts of her old mom in the new face.
“Her face was a little swollen so it’s still hard to tell, but her nose doesn’t look so different from how it was before,” she told Curry. “And the structure … it’s taking to her underlying facial structure.”
Charla’s family is immensely grateful to the family that donated the face and hands transplanted in the operation. In a statement released today they wrote:
“We wish to thank the donor and her family for giving Charla a new face and hands. We mourn the loss of your loved one and share in your sadness. Your incredible gift to Charla is generous and kind beyond words.”