After face transplant, Virginia man works on 'life given back to me'
A Virginia man who received a full-face transplant in March, after a disfiguring gun accident 15 years ago, says he's now able to walk past people without getting a second look.
The Washington Post
After a gun accident took off half his face, Richard Lee Norris spent 15 years living as a recluse in Hillsville, Va. Horribly disfigured, he hid indoors. When he ventured out, it was behind a baseball cap and a surgical mask. He didn't pursue a career and never married.
He did his shopping at night so he wouldn't face the stares of as many people.
Now, seven months after undergoing the most extensive face transplant in history, 37-year-old Norris is coming out of hiding.
"I am now able to walk past people and no one even gives me a second look," he wrote.
Thanks to potent medications and dogged determination, Norris is healing faster than anyone expected, according to his doctors at the University of Maryland Medical Center (UMMC) in Baltimore, where his transplant was performed.
"We as doctors do the operation, but the rest is up to you as the patient," said Eduardo Rodriguez, a dentist and surgeon at UMMC. "You have to carry the ball." Rodriguez says Norris took the ball and ran with it.
By the time Norris was selected as a transplant candidate in 2005, he already had undergone more than a dozen operations attempting to give him functional use of his mouth. Despite those surgeries, certain facial features — such as his lips, nose and the front of his tongue — were beyond repair.
"After several attempts at reconstruction, it became apparent it wasn't going to work," Norris, who declined to be interviewed in person, said in a written statement. "The face transplant was one of my very few options left."
The 36-hour operation was completed in March and involved more than 150 doctors, nurses and UMMC staff members.
"Everything from the scalp to the midline of my neck was replaced, including the jaw bones, teeth, part of my tongue, muscles, and nerves," said Norris, who has retained his eyesight through the gun accident and the subsequent surgeries.
The days immediately after the transplant were promising. Norris was taken off his postoperative ventilator, and within the first week he was able to shave his face and brush his teeth.
When Norris saw his new face in a mirror for the first time, he wrote, "the only thing I could do was hug Dr. Rodriguez."
Still, he spent the first two months after surgery in the hospital. The goal at that time, Rodriguez said, was to reduce inflammation and stymie the risk of rejection through high doses of immunosuppressing drugs.
In May, Norris was discharged but instructed to remain in the Baltimore area, where he could meet multiple times each week with his transplant team as well as a psychologist, a social worker, and speech and physical therapists.
Finally, Norris was allowed to return home to Hillsville, in southwest Virginia, where he does his speech-therapy "homework" and meets with his local physician. He returns to Baltimore once or twice a month for checkups with Rodriguez and other doctors.
"I have been doing very well regaining my speech back," Norris said. "Each day it improves a little more."
As with any transplant, there was a possibility that Norris's body would reject his new face. In this case, the rejection was mild and treatable, Rodriguez said.
"When people hear 'rejection,' they think, 'Oh, my God, the face is going to melt off,' " Rodriguez said. "That's not the case at all. The skin got a little bit swollen, and there was a little bit of redness. On a scale of 1 to 10," with 10 being the worst-case scenario, "this was a Grade 1 rejection."
Still, Norris is not in the clear. He continues to run the risk of rejection and he will have to take medications for the rest of his life.
Rodriguez said one of the most common questions he is asked is "How is Richard dealing with having a new face?"
"We always think that there is going to be a facial identity crisis. That's the worry of people with normal faces. We think how we'd feel if this happened to us," Rodriguez said. "But for people with disfigurements — these people have lived lives concealed from society. That's a very different and difficult recovery."
After years of going out of his way to avoid people, Norris is surprisingly comfortable socializing now, Rodriguez said.
There's still the challenge of teaching Norris, who has not eaten or spoken properly for 15 years, to use his fully functional face. "The teeth plus the tongue is a lot to get used to" when someone has gone so long without them, Rodriguez said. Additionally, minor surgery is planned for the soft tissue of his face, such as the eyelids where there is extra skin.
The world's first full face transplant took place in Spain in 2010 and is aging well two years later. The first partial transplant was done in France in 2005, and Rodriguez said its longevity is promising.
"I'd like to hit that 10-year mark with Richard," he said.
In the meantime, Norris said he is excited to fish, golf and spend time with his family and friends.
"My friends have moved on with their lives, starting families and careers," he said. "I can now start working on the life given back to me."