[Paleopsych] NYT: The Face of the Future

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The Face of the Future

[Joel Garreau's new book, _Radical Evolution: The Promise and Peril of 
Enhancing Our Minds, Our Bodies--and What It Means to be Human_ (NY: 
Doubleday, 2005) has just arrived. I am signed up to review it for _The 
Journal of Evolution and Technology_ and commenced reading it at once. 
Accordingly, I have stopped grabbing articles to forward until I have 
written my review *and* have caught up on my reading, this last going on 
for how many ever weeks it takes. I have a backlog of articles to send and 
will exhaust them by the end of the year. After that, I have a big batch 
of journal articles I downloaded on my annual visit to the University of 
Virginia and will dole our conversions from PDF to TXT at the rate of one 
a day. I'll also participate in discussions and do up and occasional meme. 
But you'll be on your own in analyzing the news. I hope I have given you 
some of the tools to do so.]


AS she waited for her pedicure at Just Calm Down, a day spa
in the Chelsea neighborhood of Manhattan, Vicki Murray, a
30-year-old homemaker, found herself engaged in heated
debate about extreme plastic surgery.

"Sure, if my face were injured or disfigured, I would think
about a transplant," Ms. Murray said, adding
matter-of-factly that under such radical conditions she
would trade in her face for a comelier model, one with, say,
the vulcanized features of Angelina Jolie. Why not? Ms.
Murray mused. "If celebrities put up their faces for auction
after they died, people would be bidding on her features all
the time."

Debbie Greengrass, a friend, pondered that assertion. "I
have nothing against plastic surgery," said Ms. Greengrass,
30, a nurse practitioner at a New Jersey fertility clinic,
"but accepting a skin transplant from an organ donor just to
look like Angelina Jolie somehow doesn't set right with me."

The women's conversation, bizarre and of a sort customarily
relegated to science fiction, was occasioned by the
groundbreaking partial face transplant two and a half weeks
ago in Amiens, France. A 38-year-old woman whose features
had been gnawed away by her Labrador retriever received
lips, a chin and a nose from a brain-dead donor. The
procedure is considered by medical experts to be too
experimental, and medically and ethically controversial, to
have cosmetic applications.

Nonetheless the prospect of being able to one day swap one's
features for a prettier, more idealized configuration seems
to have sent the imaginations of people into overdrive,
fueling discussion and over-the-top fantasies at the
proverbial water cooler.

Among doctors and nonprofessionals alike, the medical and
scientific advances that made possible the first face
transplant raise issues both practical and moral, and touch
on matters pertaining to class, wealth and the more profound
question of human identity. The idea that a face might one
day be as interchangeable as a watchband, a concept long
popularized in futuristic novels and films, engenders
reactions of mingled revulsion and awe.

"Replacing your features with those of a donor just to make
yourself prettier - that idea is abhorrent," said Sally
Cook, an author of children's books who lives in New York.
But Ms. Cook, 51, added she was deeply impressed to learn
the that procedure was available and would favor such an
operation for patients who were disfigured from birth or as
the result of an injury.

Others, however, were more willing to entertain the
possibility of a future in which a face transplant becomes a
means by which one can trade in a shopworn mug as readily as
exchanging an outmoded iPod for the newer, trimmer Nano

"We're standing on the edge of a new frontier," said Dr.
Anthony C. Griffin, a plastic surgeon in Beverly Hills, who
appears on "Extreme Makeover," the ABC reality show. Dr.
Griffin speculated that if a face transplant should become
common practice, it would be easier to obtain abroad than in
the United States. "We're too puritanical in America to ever
allow face transplants for cosmetic reasons," he said, "but
I can see someone like Michael Jackson flying to Paris for a
nose transplant, although not in my lifetime."

To many people, living at a time when plastic surgery has
lost much of its stigma - total cosmetic medical treatments
rose 24 percent over the past four years, says the American
Society of Plastic Surgeons - the idea of a new face
requires no great leap of imagination, despite the medical
hurdles. Sam Shahid, an advertising art director who once
created a magazine cover in which the model's face was a
pastiche of the features of other models, predicted that
although the notion is bound to seem horrific at first,
"once people get over the shock," it would become
"acceptable, perhaps desirable."

A new face might one day be a covetable luxury item,
suggested Scott Westerfeld, a science fiction writer, whose
novels "Uglies" and "Pretties" project a future in which a
compulsory operation at 16 makes everyone conform to an
ideal standard of beauty. In that future world, "it's not
just how much cosmetic surgery you get, it's how often," Mr.
Westerfeld said, adding, "There will come a day when having
extreme cosmetic surgery will be like buying a $1,000 Gucci
bag, an indication that you are a member of the privileged

Well before the first partial face transplant became a
reality, writers, filmmakers and other visionaries were
depicting that future as a promising, though grotesque,
inevitability. As Hanif Kureishi has his hero observe in
"The Body," his 2004 novel about a 60-year-old writer whose
brain is transferred into the fresh corpse of a young man,
"It seems logical that technology and medical capability
only need to catch up with the human imagination or will."

In October, Elle magazine published a cover depicting the
distant future, one eerily anticipating the transplant in
France. It featured Claudia Schiffer ("Still Sexy at 135!")
with a cover line asking, "How He Feels About Your Face

"We were being humorous," said Roberta Myers, the editor of
Elle, acknowledging that thanks to movies and popular
television dramas like FX's "Nip/Tuck," which explores the
outer limits of plastic surgery, and reality shows like "The
Swan," on Fox, which raises the possibility of an infinitely
mutating identity through cosmetic surgery, people might not
find the concept of a face transplant so far-fetched. (On a
"Nip/Tuck" episode last week, the face of a brain-dead young
woman was grafted onto a burn patient, whose immune system
rejected the transplant.)

Mr. Westerfeld noted that such themes, once the province of
science fiction, now parallel mainstream attitudes about the
self and identity. There is increasing acceptance that "as
human beings we get to choose who we are," he said. "And the
line between what you get to choose and don't choose is
moving all the time."

Plastic surgery first entered popular awareness in large
part through movies, in a catalog of films dating back at
least to the 1940's. In the noir classic "Dark Passage,"
Humphrey Bogart plays an escaped prisoner who seeks a
plastic surgeon to give him a new face and identity. In
"Eyes Without a Face," a 1959 French horror movie, a famous
surgeon kidnaps young women to strip off their skin and
graft it onto the face of his disfigured daughter. And in
"Seconds," a 1966 John Frankenheimer fantasy, a nondescript
aging bank clerk is transformed via surgery into a youth
with the features of Rock Hudson.

A more contemporary variation of that theme is encountered
in "Face/Off," in which a terrorist (Nicolas Cage) trades
faces with the F.B.I. agent (John Travolta) who is pursuing

Filmmakers have been persistently fascinated by plastic
surgery because, as the art historian Jürgen Müller has
written, "It is used to dramatize or reflect on the essence
of identity." In his essay "Plastic Surgery in Movies,"
published in "Aesthetic Surgery" (Taschen, 2005), Dr.
Müller, chairman of the art history department at Dresden
University, argues that in films like "Seconds" or
Face/Off," the face is both the "proof and the expression of

"In this context, a look in the mirror brings with it the
question of identity, of whether inside and outside still
correspond," he writes. Off screen, in real life, some
argue, a medical procedure that necessarily tampers with
identity might take an unacceptable psychic toll. "The
implications are shudder-worthy," said the writer Daphne
Merkin. "Can you borrow someone else's features and still be

Noting that Botox and plastic surgery have already eroded
the idea of character by erasing laugh and frown lines, she
asserted that such a face transplant might eliminate the
concept of character. "Are we equipped to deal with this
aesthetic fungibility?" she said.

In the case of the French transplant patient, Isabelle
Dinoire, critics have raised questions about the
psychological impact of having another person's features -
in this case, a donor who may have committed suicide, it was
revealed this week.

Medical experts point out that a transplant recipient would
never acquire exactly the features of another person,
because the recipient's underlying bone structure would
affect the way the skin appears.

Face transplants are difficult and controversial in large
part because of the risk that the recipient's immune system
will reject the borrowed tissue. The patients must take
strong immune-suppressing drugs for the rest of their lives,
and these may cause cancer or be toxic to the heart, doctors

The day of routine practical transplants, even of a part of
the face, is "very, very far off," said Dr. Peter G.
Cordeiro, the chief of plastic and reconstructive surgery at
Memorial Sloan-Kettering Cancer Center in New York.

And why bother with a transplant at all, some ask, when
conventional surgery will do the job? "Many people walking
around, especially celebrities, already have had so many
procedures that they no longer look like themselves," said
Dr. Frederic Brandt, a dermatologist in New York and Miami
who has a large celebrity following.

That notion is not lost on Janice Dickinson, a onetime
supermodel and the author of "Everything About Me is Fake
... And I'm Perfect" (Regan Books, 2004). Ms. Dickinson, who
acknowledged in an interview having had a number of cosmetic
procedures, including a face-lift, confided only half in
jest that she would not mind trading in her features for a
classier set. "I've been dying to look like Iman Bowie," she
said referring to the model and cosmetics entrepreneur.

Nor is the concept of a transplant as a mark of privilege
utterly alien to Suzanne Yalof Schwartz, the executive
fashion director at Glamour magazine. "If I had to have a
face transplant, why not upgrade?" Ms. Schwartz asked. "I've
lived long enough as a jalopy. I want to be a Jaguar."

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