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Wednesday, February 14, 2018

Accurately Replicating a Face Mask

"Maybe a silicone mask approximates 75 percent accuracy. A 3-D printed mask can approximate 95 percent."
"[The finished mask is rushed to the hospital] because we want to procure the face while it is still being perfused by a beating heart."
"Their [donor relatives] primary focus was to see their son help out as many people as possible."
"We try to respect the dignity of an individual who gave up his face or her face."
Eduardo Rodriguez, director, NYU Langone face transplant program
The mask is made of hard plastic but captures the subtleties of a flesh and blood face.

And to accomplish what Dr. Rodriguez described, it was conceived that a more accurate-in-appearance and -texture mask of a deceased's face, true to the original, removed for the purpose of a face transplant operation, would allow the grieving family of the dead donor to see the body apparently undisturbed, to enable them to have a last long, lingering look at the remains of what recently was a living, loving family member. Its verisimilitude would give the mourners a feeling of closure.

To accomplish this last farewell with the respect and dignity it deserves, the brain-dead individual is wheeled into the plastic surgery department at New York University Langone Medical Center in Manhattan where a technician runs a scanner over the face which then minutely records the most minuscule detail of a face that will be repeated with the greatest degree of visual accuracy at a laboratory associated with the university, through the medium of a 3-D printer.

A 3D printer puts down thousands of layers of plastic to build the mask

This will give the green light to awaiting surgeons to detach the dying person's face and prepare to attach it to another person who has been on a wait-list for a face transplant. Printing experts attached to New York University will then aim their expertise at generating a facial replica of the scanned face of the donor, sufficiently lifelike to enable his family members to feel confident in its use in an open coffin during the subsequent funeral.

At the present time, silicone masks cast from moulds with painted features have been available; not as lifelike nor as faithful to the original. Dr. Rodriguez in 2015 performed an extensive transplant for a former firefighter from Mississippi whose face, exposed directly to fire through his line of duty, melted away. Consequently he has lived in a waiting game, his name on a list for over a year, for the opportunity to regain a new face, through the generosity of a donor.

A 26-year-old Brooklyn bicycle mechanic by the name of David Rodebaugh, victim of a cycling accident, remained comatose when his family met with Dr. Rodriguez asking how their dying family member's body would appear, understanding when he responded that the silicone mask had its limitations. Nonetheless they agreed to proceed with the face removal. That anxiety led to Dr. Rodriguez's search for a more accurate face mask to preserve the dignity of the dead donor.

On the donor's death, the mask is placed atop his stripped face; covering the seam where mask meets hairline it is difficult to discern that it is a mask and not the individual's original face. When the face printing is set to proceed, a hand-held device scans the donor's face pre-detachment, with five camera lenses, capturing details from multiple angles, then projects a grid onto the face to produce a three-dimensional 'map'. Hours are then spent arranging files on computers to send them to a printer full of acrylic-based photopolymer cartridges.

At this point layers so compressed that 600 of them makes up a centimeter are laid down by the printer. It takes over 24 hours for the printer to complete a face mask that might require ten thousand infinitesimally thin layers. On completion, technicians rush the mask to the hospital where the donor's face will have been removed while he is on life support. With this more accurate reproduction of an individual's face, the hope is that more families will be encouraged to agree to permitting a loved one's face to be used for transplant purposes.

Leslie Bernstein, an NYU Langone administrator, had her face scanned to make a demonstration mask

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