Some thir­teen years after the first suc­cess­ful par­tial face trans­plant oper­a­tion per­formed by Prof. Bernard Devauchelle at the teach­ing CHU hos­pi­tal at Amiens, a book enti­tled “Faire face, faire vis­age” [The Courage to remake a Face] pub­lished in the col­lec­tion “Encre marine des Belles Let­tres”. This excep­tion­al sci­en­tif­ic, tech­no­log­i­cal and human adven­ture is revealed via eye­wit­ness accounts and analy­ses of prac­ti­tion­ers, philoso­phers and the patients. 

This book rep­re­sents one of the sup­ports imple­ment­ed in the frame­work of the sci­en­tif­ic pro­gramme «“Tech­nolo­gies and Human Traces” admin­is­tered by the UTC-COSTECH lab, who addressed the issues involved in trans­plant oper­a­tion. It is the result of orig­i­nal research inves­ti­ga­tions car­ried out by sev­er­al research sci­en­tists in the field of Phi­los­o­phy, who spent 15 days in com­plete immer­sion at the max­il­lo-facial surgery unit of the CHU Amiens. 

It was an expe­ri­ence that enabled François Seb­bah – a for­mer UTC-COSTECH Direc­tor, cur­rent­ly Pro­fes­sor of Con­tem­po­rary Moral Phi­los­o­phy at the uni­ver­si­ty Paris Nan­terre and Aurore Mré­jen, PhD in phi­los­o­phy and research sci­en­tist at the LCSP (Lab­o­ra­to­ry for Social and Polit­i­cal Change) at the uni­ver­si­ty Paris Diderot, to crit­i­cal­ly assess the the­o­ry devel­oped by philoso­pher Emmanuel Lév­inas about the role face play in our rela­tion­ships to oth­ers, in regard to the real­i­ties expe­ri­enced by prac­ti­tion­ers and patients. 

Going beyond the strict the­o­ret­i­cal dimen­sions, this approach allowed the authors to analy­ses in depth this debate over and above its pure­ly aes­thet­ic con­sid­er­a­tions. When, for instance, is it legit­i­mate to pro­pose that a patient in good health oth­er­wise accepts to under­go a face trans­plant oper­a­tion, with its risks? The answer can only come case by case. The text by Dr Sophie Cré­mades, a psy­chi­a­trist at the CHU Amiens and the expe­ri­ence relat­ed by two per­sons who have ben­e­fit­ed from facial recon­struc­tion surgery serve to demon­strate the com­plex role played by our faces in the rela­tion­ship to our­selves and to oth­ers. Judg­ing by these var­ied points of view, we can see that our face is more than just an ‘organ’; indeed it is a mark of our ‘human­i­ty’, with its capac­i­ty to con­vey feel­ings and its vul­ner­a­bil­i­ty. The pluridis­ci­pli­nary med­ical team that sur­round face trans­plant oper­a­tions takes all these psy­cho­log­i­cal and social fac­tors into account. 

A pluridisciplinary approach

The four texts that con­sti­tute the book describe the face trans­plant oper­a­tion and its pro­to­cols and try – each in a spe­cif­ic man­ner – to relate, as best they can, the expe­ri­ence to its deep­er mean­ing. The texts inter­mesh and echo each oth­er. The third Part of the book is an exchange with Pro­fes­sor Bernard Devauchelle, Head of the Max­il­lo-Facial Surgery Unit at the CHU Amiens. This par­tic­u­lar text throws light on the need to com­bine tech­ni­cal vir­tu­os­i­ty for what is an extreme­ly com­plex oper­a­tion and an under­stand­ing of the patient’s per­son­al­i­ty, in order to rebuild a face that ‘lives’, con­veys feel­ings and the per­son­al ‘his­to­ry’ of its owner. 

Prof. Devauchelle was delight­ed to wel­come the aca­d­e­m­ic mis­sion, its mem­bers being total­ly unfa­mil­iar with the world of med­i­cine. “Inter­dis­ci­pli­nar­i­ty lies at the core of what we have been doing for 20 years now, with projects that involve his­to­ri­ans, soci­ol­o­gists, anthro­pol­o­gist and engi­neers … we attach a high degree of impor­tance to research activ­i­ties and to inno­va­tion”. Inas­much as he is an enthu­si­ast for art, his­to­ry and phi­los­o­phy, the atyp­i­cal sur­geon Bernard Devauchelle is also a dri­ving force for numer­ous extra-med­ical projects with ‘Faire Face’ – PIA, an insti­tute of which he was co-founder. The ‘Insti­tut’ car­ries out research for med­ical, tech­nol­o­gy-inten­sive and human­is­tic purposes. 

There is also an exhi­bi­tion and stud­ies on WW1 in a part­ner­ship with a British uni­ver­si­ty and a sur­vey of the masons’ work restor­ing stone faces on the Cathe­dral of Amiens, com­pared with the sur­geons who look after patients today. These are rich forms of col­lab­o­ra­tion that open up new prospects for fur­ther research. The book “Fair Face, faire vis­age” per­fect­ly holds its rank among ini­tia­tives that involve social sci­ences, human­i­ties and Soci­ety at large. n 

Faire face, faire visage. 

Amiens, Hôpi­tal Nord, dix ans après la pre­mière greffe.

Col­lec­tion encre marine, édi­tions Les Belles lettres