Patients who receive a facial transplant have to adapt their identities to their new appearance, according to a new study.
Professor Manos Tsakiris of Royal Holloway, University of London, UK, and colleagues explained in the Proceedings of the National Academy of Sciences on Monday that: “Recognition of one’s own face is a hallmark of self-awareness.”
They investigated what happens when the face is altered or replaced through facial transplantation, by carrying out a long-term study of one patient’s journey before a life-changing injury, during the injury, and after facial transplantation.
The surgery was done at the Department of Plastic Surgery at New York University, USA. Prior to the surgery, the team analysed the individual’s recognition of their own face by examining brain responses in a self-face recognition task.
After the face transplant and over the following 28 months, the team repeated the face recognition tests.
This highlighted which brain networks are involved in self-face recognition. Over a period of 20 months, brain activity showed that the patient gradually recognised their new appearance as their own face.
One key brain area involved was the medial frontal cortex, which is known to be linked to the sense of identity.
“These changes and underlying neural processes highlight how the malleable representations of our face ensure the self’s continuity over time,” the authors write.
Professor Tsakiris said: “While the acquisition of a new face following facial transplantation is a medical fact, the experience of a new identity is an unexplored psychological outcome.
“These changes require some adaptation on our own behalf and an updated sense of self. Plasticity and continuity of the self are particularly relevant for modern selves who, due to technological or medical advances, seem to be exposed to new, often radical, possibilities of change.”
Azevedo, R. T. et al. Re-cognizing the new self: The neurocognitive plasticity of self-processing following facial transplantation. Proceedings of the National Academy of Sciences 27 March 2023 doi: 10.1073/pnas.2211966120
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