Doctors Work to Restore Damaged Faces of Iraq War Soldiers

SUSAN DENTZER: Mittman's wife, Christy, recalls what happened when she first saw her husband at the Walter Reed Army Medical Center in Washington, D.C.

CHRISTY MITTMAN: The nurse sat there with me the whole first night, and he told me -- he said "You know," he said, "30 years ago, like in Vietnam," he said, "more than likely your husband would not have made it off the battlefield." He said, "But he's here," and he goes, "I've seen it. They will get him looking almost perfectly the way that he did before he got hurt." And I called them liars.

SUSAN DENTZER: What would you call them today?

CHRISTY MITTMAN: Angels from God; that's what I would call them, because, you know, he didn't have a nose three months ago, and he does now.

DR. JOE ROSEN, Plastic Surgeon: Look out into the future would be to readdress this area.

SUSAN DENTZER: One of those whom Christy considers an angel is Mittman's plastic surgeon, Joe Rosen. He normally practices at Dartmouth Hitchcock Medical Center in New Hampshire but was called in by Walter Reed as a consultant on Mittman's and others' cases.

Rosen talked with Mittman before one recent surgery.

DR. JOE ROSEN: So when we approach someone like you, the reason it's complicated is because, not only do we have to make you a nose, but we also have to build a foundation for the nose. So we needed a piece of bone, and you can feel down here that piece of bone so that we can rest your nose on it.

So where we got that piece of bone, in your case, was we got it here from your forearm. And we took that piece of bone off, we actually cut it and put it in your face, and then wrapped the skin around it to create lining in your mouth and also a foundation, your upper lip, and also lining for your nose.

SUSAN DENTZER: Rosen went on to describe how the surgical team actually crafted the new nose, from a leaf-shaped slice of Mittman's forehead skin stretched over pieces from his ribs.

DR. JOE ROSEN: So if you imagine a tent that has struts in it, and then the covering of the tent is the forehead skin, the covering goes down on those struts.

JEFFREY MITTMAN: All this is from my forehead, so when I actually touch here, it really feels like my forehead. It feels like I'm touching here. You know, I've kind of cross-circuited all over. You can also see the hairline here which will be -- they'll correct that also during some of the procedures.

SUSAN DENTZER: Rosen told Mittman that, in future surgeries, he'd whittle down the nose to a more refined shape.

DR. JOE ROSEN: Plastic surgery is really a battle between beauty and blood supply, so we can only do so much at each stage without endangering what we've done. But if we're willing to be patient, sort of a two-year process, then each three months we can do another stage and make it better and better until you're satisfied. Now, one of the issues is that we can never make you normal again, but we can make you appear very good.

JEFFREY MITTMAN'S DAUGHTER: Yes.

SUSAN DENTZER: Aside from looks, we asked Mittman how much of his facial function has been restored, given the overwhelming damage to the many nerves and more than 50 muscles that make up the normal human face.

JEFFREY MITTMAN: My lower lip is numb, and my upper lip I don't have, you know, total control over. It makes it a little hard to eat and a little hard to drink. So I drink through a straw; everything I drink is through a straw.

My sense of taste is also affected. I really don't taste sweets, so I don't taste, you know, candy. I don't have any taste -- I taste salt with it.

How much do you love Daddy?

SUSAN DENTZER: Most of all, of course, he can't smile or frown, the basic facial expressions that make up so much human interaction.

JEFFREY MITTMAN: It's not the end of the world. You have to keep going. You know, you take from my experience what you can and realize that, you know, there's always tomorrow, so...

CHRISTY MITTMAN: You know, it could be worse. You know, he could be in the ground. So, you know, we'll take what we can get, and they'll fix it slowly but surely.

So recently, the Defense Advanced Research Projects Agency, or DARPA, brought together a range of physicians and scientists to explore futuristic options for restoring a human face.

DR. ANTHONY ATALA, Director, Institute for Regenerative Medicine: So here are actually the incubators, which are in the same conditions as the human body.

SUSAN DENTZER: One of those who attended the DARPA workshop was Dr. Anthony Atala of Wake Forest University in North Carolina. He's a pioneer in a field called tissue engineering.

DR. ANTHONY ATALA: And these are the molds that will be used for cell seeding, so the cells will be seeded in these molds.

SUSAN DENTZER: In their lab, Atala and his research team are actually taking bone, muscle and blood vessel cells from individuals, then growing them into tissues to put back into the same people. They say these techniques could help future Jeffrey Mittmans.

DR. ANTHONY ATALA: We would first start by growing a piece of bone for his face, and then a pieces of muscle for his face, and then a skin for that particular area. And then we'd just really build upon the whole construct one step at a time.

All we really need to bring these technologies faster to reality is a concerted national effort to be able to invest in these technologies that we know have a high potential of benefiting patients throughout the world.

SUSAN DENTZER: Another possibility discussed at the DARPA workshop was an advanced facial prosthesis, along the lines of a robot named Jules. It's now being built in the Dallas, Texas, lab of engineer David Hanson.

Hi, Jules, how are you doing today?

JULES, Robot: I'm fine, Susan, how are you? How's Jim Lehrer doing?

SUSAN DENTZER: Hanson and his colleagues built Jules out of a sophisticated skin-like material they developed, dubbed "Frubber." A network of tiny motors powered by a nine-volt battery stands in for facial muscles, changing the robot's expressions.

Hanson says a robotic prosthetic could be combined with tissue engineering techniques to build a composite face that could even smile, frown, or chew.

DAVID HANSON, Hanson Robotics: If we can create these technologies to address our combat injuries, then we can alleviate so much misery in the world. We're at a time in history where these things are possible.