Plastic and Regenerative Surgery
Plastic surgeons and plastic surgery researchers are creating regenerative therapies for a broad range of conditions, including injuries to the hands, face and limbs.
For people who've lost tissue due to cancer, burns or other trauma, reconstructive options can be limited to moving tissue from one part of the body to another or trying to stimulate new tissue growth within the injured area. But for major injuries, such as limb amputation and severe facial trauma, very few effective treatment options exist.
In the Center for Regenerative Medicine, Mayo Clinic plastic surgeons and researchers are developing regenerative medicine-based treatments for people with congenital anomalies of the hands and face, such as microtia, cleft lip and cleft palate; burns; limb and muscle loss; facial aging; facial nerve injuries; breast cancer; and other reconstructive needs.
- Hand transplantation. In 2010, Mayo Clinic started the Hand Transplant Program, which is the first such clinical program in the U.S. During a hand transplant, a person who's had one or both hands amputated receives hands and a portion of the forearms from a donor.
- Face transplantation. In 2013, Mayo Clinic started a clinical face transplant program for people with congenital diseases or who've experienced severe facial trauma. This program will build on Mayo's existing expertise in head, neck and face reconstruction.
- Facial reanimation. Mayo Clinic's facial reanimation program treats patients who've lost movement in part of their faces. These include children and adults with facial nerve injuries; children born without a facial nerve, meaning they can't smile; and adults who've had tumors or experienced trauma. To restore lost function, Mayo surgeons may use nerve grafts and muscle transfers.
Additionally, a generous gift from the Obaid family provides funding for several plastic and regenerative surgery research projects each year. Projects supported include:
Preclinical modeling. Researchers are developing an animal model to study stem cell repopulation of a decellularized limb — a limb in which all the cells have been removed.
After using this preclinical model to better understand limb recellularization, Mayo investigators can begin trials using human tissue. Researchers believe this will lead to an ability to effectively reconstruct some facial anomalies, such as those of the nose and ear.
- Immunosuppression. For hand and face transplants to be successful, the recipient's nerves must regrow into the transplanted region. As immunosuppression is required for patients receiving such transplants, research is underway to study the effects of immunosuppression on nerve regeneration.
Psychological assessment. Hand and face transplants are life changing for patients, but require years of monitoring and rehabilitation. This means patients must have strong social support systems in place before and after their procedures.
With this project, researchers are developing a standardized preoperative psychological assessment for patients wishing to undergo vascularized composite allotransplantation, which includes hand and face transplants.
Other active areas of research and clinical practice include:
- Nerve reconstruction
- Fat stromal cell injection
- Artificial skin
- Targeted muscle reinnervation for patients with amputations
- Functional muscle transfers