Tuesday, October 16th, 2012
The University of Maryland released details today on the recovery of Richard Lee Norris, the 37-year-old man who received the most extensive full face transplant completed to date seven months ago. Norris, of Hillsville, Virginia, was injured in a 1997 gun accident, losing much of his upper and lower jaws as well as his lips and nose. The transplant surgery, completed on March 20, 2012 at the University of Maryland Medical Center, included replacement of both jaws, teeth, tongue, and skin and underlying nerve and muscle tissue from scalp to neck.
"For the past 15 years I lived as a recluse hiding behind a surgical mask and doing most of my shopping at night when less people were around," says Norris. "I can now go out and not get the stares and have to hear comments that people would make. People used to stare at me because of my disfigurement. Now they can stare at me in amazement and in the transformation I have taken. I am now able to walk past people and no one even gives me a second look. My friends have moved on with their lives, starting families and careers. I can now start working on the new life given back to me."
"I am doing well. I spend a lot of my time fishing and working on my golf game. I am also enjoying time with my family and friends" says Norris. "I do still have follow-up appointments with a lot of different doctors and therapists to ensure everything is healing up properly. I have been undergoing physical therapy and also speech therapy. I have been doing very well regaining my speech back. Each day it improves a little more."
Norris continues to gain sensation in his face and is able to smile and show expression. His doctors say the motor function on the right side of his face is about 80 percent normal, and motor function on the left side is about 40 percent. He eats primarily by mouth and is able to smell and taste.
Norris’ historic 36-hour full face transplant was led by Eduardo D. Rodriguez, M.D., D.D.S., professor of surgery at the University of Maryland School of Medicine and chief of plastic, reconstructive and maxillofacial surgery at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center. Norris’ surgery marked the first time in the world that a face transplant was performed by a team of plastic and reconstructive surgeons with specialized training and expertise in craniofacial surgery and reconstructive microsurgery.
"Our goal for Richard from the beginning was to restore facial harmony and functional balance in the most aesthetic manner possible through the complex transplantation of the facial bones, nerves, muscles, tongue, teeth and the associated soft tissues," says Dr. Rodriguez. "Richard is exceeding my expectations this soon after his surgery, and he deserves great deal of credit for the countless hours spent practicing his speech and strengthening his new facial muscles. He’s one of the most courageous and committed individuals I know."
Within days after surgery, Norris was also working with physical, occupational and speech therapists to begin the detailed process of re-gaining functional use of his new face, tongue and jaw. A significant part of the surgery was dedicated to preserving and re-connecting nerves from the donor face to Norris’ own nerves. The rehabilitation team continues to work with Richard to train these nerves to talk to each other to restore normal movement and speech.
As with any transplant surgery, the potential rejection of the donated tissue is an aspect to be carefully monitored. Norris’ complex immunosuppression regimen is managed by Rolf Barth, M.D., associate professor of surgery at the University of Maryland School of Medicine and director of liver transplantation and hepatobiliary surgery at University of Maryland Medical Center. Dr. Barth’s research focuses on ways to reduce rejection of donated organs and minimize the side effects of long-term immunosuppressive use after transplantation.
"We began this research more than 10 years ago when we saw the devastating injuries sustained by soldiers in Iraq and Afghanistan from improvised explosive devices," says Stephen T. Bartlett, M.D., Peter Angelos Distinguished Professor and chair of the Department of Surgery at the University of Maryland School of Medicine, and surgeon-in-chief and senior vice president at the University of Maryland Medical System. "Now having seen how this surgery has changed Richard’s life, we are even more dedicated to researching ways to improve facial transplantation and helping more patients, including military veterans, return to normal lives after undergoing this same surgery."
Efforts are underway to expand the University of Maryland facial transplantation program to serve additional patients, including military personnel and veterans wounded in action. Norris’ face transplant was the result of more than 10 years of research made possible by grant funding received from the Office of Naval Research in the Department of Defense and secured by Dr. Bartlett to research composite vascularized allografts for soldiers with facial injuries caused by improvised explosive devices.
"The results we’re seeing in Mr. Norris today are a reflection of the collaboration between our research and clinical teams who have worked tirelessly to give him a return to normalcy," says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine.
Norris added: "Thanks to all the people and organizations that made this possible: the grant from the Department of Defense’s Office of Naval Research; The R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center; Dr. Eduardo Rodriguez, his team and staff; Angel Flight Mid Atlantic; The Living Legacy Foundation of Maryland; and the family of the donor whose organs also saved the lives of five other people."
About the University of Maryland School of Medicine,
University of Maryland Medical Center &
R Adams Cowley Shock Trauma Center
Founded in 1807, the University of Maryland School of Medicine in Baltimore is the oldest public medical school in the United States, and the first to institute a residency training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. The partnership between the University of Maryland Medical Center (UMMC) and the University of Maryland School of Medicine allows cutting edge medical research and discovery to rapidly innovate and improve patient care and prepare the next generation of health care professionals through excellent training and education.
The University of Maryland Medical Center (UMMC) is a 779-bed teaching hospital in Baltimore and the flagship institution of the 11-hospital University of Maryland Medical System. Patients are referred nationally and regionally for advanced medical, surgical and critical care. All physicians on staff at the Medical Center are faculty physicians of the University of Maryland School of Medicine.
The R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center is the nation's first coordinated trauma system and is dedicated to multidisciplinary research and treatment of critical injury and illness. Shock Trauma is where the "golden hour" concept in critical care medicine was born. Under the direction of Thomas M. Scalea, M.D., Shock Trauma treats more than 8,000 trauma and critical care patients each year and trains trauma providers from around the world including U.S. military medical professionals.