1 00:00:08,480 --> 00:00:11,480 They say that eyes are like mirrors. 2 00:00:12,600 --> 00:00:14,320 Whether they stare or look away, 3 00:00:14,480 --> 00:00:18,320 Jérôme senses the strange feelings of those looking at his face. 4 00:00:18,840 --> 00:00:20,280 A mixture of astonishment 5 00:00:21,200 --> 00:00:22,400 and fear. 6 00:00:26,200 --> 00:00:28,000 I've always been like this. 7 00:00:28,400 --> 00:00:30,560 I've always lived like this. 8 00:00:30,720 --> 00:00:32,640 - It is your face. - It is. 9 00:00:33,080 --> 00:00:37,040 But it's difficult to cope with how people look at me. 10 00:00:37,560 --> 00:00:40,880 It's because of, or thanks to, the way they look at me, 11 00:00:41,040 --> 00:00:44,760 that I feel like improving things, 12 00:00:44,920 --> 00:00:47,280 to become anonymous, 13 00:00:48,520 --> 00:00:50,640 to be like everybody else. 14 00:00:50,800 --> 00:00:52,880 - To be unobtrusive? - To blend in. 15 00:00:53,040 --> 00:00:54,760 To blend into the crowd. 16 00:00:54,920 --> 00:00:57,400 - That'd be ideal. - It would be. 17 00:00:58,960 --> 00:01:02,280 Jérôme is 33 but his face is ageless. 18 00:01:02,480 --> 00:01:05,720 A disease has made his skin heavy since he was small. 19 00:01:05,880 --> 00:01:09,160 It has eaten up his forehead, his cheeks, his eyes. 20 00:01:09,320 --> 00:01:11,600 It has frozen his facial expressions 21 00:01:11,800 --> 00:01:13,000 between folds. 22 00:01:14,160 --> 00:01:17,720 On the Champs-Élysées, Abdel-Rahman's mind is elsewhere. 23 00:01:17,880 --> 00:01:21,440 His parents have been visiting children's hospitals for years, 24 00:01:21,640 --> 00:01:24,800 in the quest to get their child a new face. 25 00:01:24,960 --> 00:01:26,760 From Kuwait City to Paris, 26 00:01:26,960 --> 00:01:30,880 the breadth of their travel equals the magnitude of their hopes. 27 00:01:34,680 --> 00:01:36,960 What would be left of our faces, 28 00:01:37,160 --> 00:01:40,360 were it not for our eyes or our expressions? 29 00:01:41,560 --> 00:01:44,680 What can be read from these pictures? 30 00:01:46,920 --> 00:01:48,120 It's ugly. 31 00:01:49,840 --> 00:01:51,520 It's ugly, so... 32 00:01:52,720 --> 00:01:54,560 It isn't normal. 33 00:01:55,760 --> 00:01:57,880 - Does it scare you? - It does. 34 00:01:59,280 --> 00:02:03,880 A face like this is frightening, indeed. 35 00:02:04,040 --> 00:02:05,200 It's not normal, 36 00:02:06,040 --> 00:02:07,920 so you run away. 37 00:02:12,600 --> 00:02:14,600 Like thousands of people each year, 38 00:02:14,760 --> 00:02:16,680 Mrs Lemaguère wishes to erase 39 00:02:16,880 --> 00:02:19,960 the consequences of a disease or an accident. 40 00:02:20,120 --> 00:02:22,440 Let's pull back the hair. 41 00:02:22,600 --> 00:02:24,680 - My camouflage. - It's a good one. 42 00:02:24,880 --> 00:02:26,920 We agreed to reposition 43 00:02:27,400 --> 00:02:29,240 the external part, 44 00:02:29,440 --> 00:02:33,040 and try and fill this hole, here. 45 00:02:33,200 --> 00:02:35,080 - With an implant. - Yes. 46 00:02:38,040 --> 00:02:41,080 Exactly what do you rebuild when you rebuild a face? 47 00:02:41,240 --> 00:02:43,760 Do you need to risk your life for a new look? 48 00:02:45,040 --> 00:02:46,440 What challenges and limits 49 00:02:46,760 --> 00:02:50,480 do surgeons set for themselves, behind these faces? 50 00:02:57,200 --> 00:03:00,200 BEHIND THE MIRROR 51 00:03:06,800 --> 00:03:11,320 8:00am, Henri Mondor Hospital, in Créteil. 52 00:03:11,480 --> 00:03:14,280 This is Prof. Lantieri's first operation of the day, 53 00:03:15,440 --> 00:03:17,880 the first day of her long-awaited new face 54 00:03:18,080 --> 00:03:20,320 for Mrs Lemaguère, already under anaesthetic. 55 00:03:26,440 --> 00:03:28,280 There's a nerve here. 56 00:03:28,480 --> 00:03:30,000 It's the frontal nerve. 57 00:03:30,160 --> 00:03:32,640 It accounts for movement of the forehead. 58 00:03:32,800 --> 00:03:35,760 If we start here and I get in deep, 59 00:03:35,920 --> 00:03:38,000 too deep, I'll cut the nerve. 60 00:03:38,160 --> 00:03:39,840 Her forehead won't move again. 61 00:03:40,000 --> 00:03:42,080 In order to get deep in there, 62 00:03:42,240 --> 00:03:45,040 we have to start at the back of the head, 63 00:03:45,200 --> 00:03:47,400 and scalp it all, to reach the bone. 64 00:03:47,560 --> 00:03:50,680 Then we can insert the implant, deep in there, 65 00:03:50,840 --> 00:03:52,080 close to the bone. 66 00:03:54,200 --> 00:03:55,520 Surprisingly, 67 00:03:55,800 --> 00:03:57,760 modifying a face 68 00:03:57,960 --> 00:03:59,280 isn't only about skin. 69 00:04:00,440 --> 00:04:05,000 In this small, stratified world, going deep is the key. 70 00:04:06,400 --> 00:04:08,640 A face is defined by its bone structure? 71 00:04:08,800 --> 00:04:09,960 It's really 72 00:04:10,240 --> 00:04:12,200 what gives a face its identity. 73 00:04:12,520 --> 00:04:16,160 The depth determines the personality. 74 00:04:16,320 --> 00:04:19,960 The surface determines expressions, movements and functions. 75 00:04:22,760 --> 00:04:27,600 If I peeled this young woman's face off completely, 76 00:04:27,760 --> 00:04:29,000 I'm not going do it, 77 00:04:29,160 --> 00:04:34,240 and attached it to this young man's bone structure, 78 00:04:34,400 --> 00:04:37,520 his bone structure would shape his expressions, 79 00:04:37,680 --> 00:04:40,200 much more than her face. 80 00:04:40,360 --> 00:04:41,560 Indeed. 81 00:04:44,640 --> 00:04:46,800 Now we're making dough, 82 00:04:47,720 --> 00:04:52,320 to fill the area where there's a hole. 83 00:04:53,440 --> 00:04:57,000 Well-placed, this small cement implant is going to change 84 00:04:57,200 --> 00:04:59,320 the whole morphology of the face. 85 00:04:59,520 --> 00:05:02,080 Once inside, it's going to heat up a lot. 86 00:05:02,240 --> 00:05:04,200 So we need to spray it constantly. 87 00:05:12,720 --> 00:05:15,520 The implant is visible here. 88 00:05:15,680 --> 00:05:19,840 We have molded it in situ to fill this hole, here. 89 00:05:20,040 --> 00:05:21,360 It's very impressive. 90 00:05:21,520 --> 00:05:23,400 It is impressive surgery. 91 00:05:23,560 --> 00:05:25,760 We're really scalping the patient. 92 00:05:25,920 --> 00:05:29,280 It's like we're really peeling the face off, 93 00:05:29,440 --> 00:05:31,280 the facade of the bone structure, 94 00:05:31,440 --> 00:05:34,080 to work on the bone structure. 95 00:05:34,240 --> 00:05:38,920 It's impressive to you because what you view as the person, 96 00:05:39,080 --> 00:05:42,720 we analyze as a mere anatomical structure, 97 00:05:42,880 --> 00:05:44,960 an organ that we're treating. 98 00:05:48,440 --> 00:05:51,040 In a few hours, Mrs Lemaguère will discover 99 00:05:51,240 --> 00:05:53,080 the face she's been expecting. 100 00:05:53,240 --> 00:05:56,680 Such patients don't wish to look prettier or to be perfect. 101 00:05:56,840 --> 00:05:59,400 They just want to look normal. 102 00:05:59,560 --> 00:06:02,000 What is a normal face? 103 00:06:02,160 --> 00:06:05,760 It isn't about beauty, aesthetics or nose size. 104 00:06:05,920 --> 00:06:08,560 From face to mask, from one culture to another, 105 00:06:08,720 --> 00:06:11,440 it's all about symmetry and harmony. 106 00:06:11,600 --> 00:06:13,600 Exactly what surgery aims for. 107 00:06:16,000 --> 00:06:17,480 Back to the hospital, 108 00:06:17,680 --> 00:06:20,000 an ordinary day of consultation, 109 00:06:20,160 --> 00:06:24,080 at the Maxillofacial unit in Amiens. 110 00:06:25,640 --> 00:06:28,240 Each face has a story, 111 00:06:28,440 --> 00:06:31,240 but these faces have no mystery: cancer, dog bites 112 00:06:31,440 --> 00:06:33,120 accidents, gunshot wounds. 113 00:06:33,640 --> 00:06:34,440 Reconstruction, 114 00:06:34,640 --> 00:06:36,760 everyday. 115 00:06:39,760 --> 00:06:43,080 Very often, a new face will change one's character. 116 00:06:45,040 --> 00:06:48,400 - What did you want to fix next? - The nose. 117 00:06:49,240 --> 00:06:53,080 Three years ago, Jérôme tried to shoot himself. 118 00:06:53,240 --> 00:06:56,360 He's had 25 surgeries to be able to smile again, 119 00:06:56,520 --> 00:06:59,000 but his face isn't finished yet. 120 00:06:59,160 --> 00:07:02,040 - You don't like the tip. - Nor the width. 121 00:07:02,200 --> 00:07:04,160 - Nor the width. - Maybe finer. 122 00:07:04,360 --> 00:07:06,880 A nose should be in the middle. 123 00:07:07,040 --> 00:07:09,600 - It bothers you? - I can see people. 124 00:07:09,800 --> 00:07:12,080 That's what they notice first. 125 00:07:12,240 --> 00:07:14,640 So we should work on the width. 126 00:07:14,800 --> 00:07:15,800 Here at the base? 127 00:07:15,960 --> 00:07:17,680 - A bit higher? - Yes. 128 00:07:17,840 --> 00:07:18,840 OK. 129 00:07:20,240 --> 00:07:23,720 For 3 years, this face project has kept him going. 130 00:07:23,880 --> 00:07:25,400 Is it like being reborn? 131 00:07:25,600 --> 00:07:28,920 It is. It will be like a revival. 132 00:07:29,080 --> 00:07:33,040 It's the same person, 133 00:07:33,200 --> 00:07:35,600 but some things will have changed, 134 00:07:35,760 --> 00:07:37,600 and they will come back... 135 00:07:38,320 --> 00:07:39,640 I can't explain it. 136 00:07:39,800 --> 00:07:42,920 It makes you want to go on. 137 00:07:43,080 --> 00:07:47,520 I was so low that it can't get any worse than it was. 138 00:07:47,680 --> 00:07:49,200 I'm moving on now, 139 00:07:49,360 --> 00:07:51,040 I'm focused on that. 140 00:07:52,040 --> 00:07:55,240 So, building your new face, 141 00:07:55,400 --> 00:07:57,600 enables you to build a new life? 142 00:07:57,800 --> 00:08:00,080 Exactly. And a better one, at that. 143 00:08:00,240 --> 00:08:01,720 I feel way better now. 144 00:08:02,320 --> 00:08:04,800 - It's given you purpose? - Yes. 145 00:08:04,960 --> 00:08:07,720 That's what you need in life. Purpose. 146 00:08:09,480 --> 00:08:12,520 A young man's hopes rest in his surgeon's hands. 147 00:08:12,680 --> 00:08:13,600 Alright. 148 00:08:15,680 --> 00:08:17,640 Always give them hope. 149 00:08:17,800 --> 00:08:19,760 Never tell them 150 00:08:19,960 --> 00:08:23,080 that we can't improve the reconstruction. 151 00:08:23,240 --> 00:08:24,840 Never tell them it's over. 152 00:08:25,040 --> 00:08:27,640 It makes them feel like we're letting them down, 153 00:08:27,800 --> 00:08:31,160 like it's over and done with for them, 154 00:08:31,320 --> 00:08:34,840 they won't see any surgeon anymore and all hope is lost. 155 00:08:35,760 --> 00:08:38,040 It's bound to depress them, surely. 156 00:08:38,200 --> 00:08:39,120 Give them hope. 157 00:08:39,280 --> 00:08:43,120 Wait until the patient says: "It's good enough." 158 00:08:49,280 --> 00:08:52,400 Jérôme has two lovely reasons to get back on track. 159 00:08:53,640 --> 00:08:55,760 His daughters, Célia and Marie. 160 00:09:02,840 --> 00:09:04,040 Who's the best? 161 00:09:04,680 --> 00:09:07,240 Well, it's me! 162 00:09:07,400 --> 00:09:09,080 It's you? Alright! 163 00:09:11,200 --> 00:09:15,200 He plays football with the Beauvais Reds in Picardy. 164 00:09:15,360 --> 00:09:17,760 On the field, no one judges him. 165 00:09:17,920 --> 00:09:20,120 He's a player like the others. 166 00:09:20,280 --> 00:09:21,840 Go, Daddy, go! 167 00:09:22,280 --> 00:09:24,200 Go, Daddy, go! 168 00:09:24,360 --> 00:09:27,160 He has just a few more supporters on his side. 169 00:09:29,120 --> 00:09:33,720 It's the story of a great victory, even when his team loses. 170 00:09:41,560 --> 00:09:43,680 Back to the hospital. 171 00:09:44,920 --> 00:09:46,240 Mrs Brémaud 172 00:09:46,520 --> 00:09:48,160 is not in for a good night. 173 00:09:54,320 --> 00:09:57,120 Tomorrow, surgeons will break half of her jaw, 174 00:09:57,800 --> 00:09:59,920 remove a tumor and rebuild her face, 175 00:10:00,080 --> 00:10:02,200 all during a single operation. 176 00:10:02,560 --> 00:10:04,680 If I make an incision... 177 00:10:04,840 --> 00:10:07,080 The surgery will last about 10 hours. 178 00:10:07,240 --> 00:10:10,120 - Way on the outside. - Yes, compared to... 179 00:10:10,760 --> 00:10:13,040 We'll cut at the top here, 180 00:10:13,240 --> 00:10:16,400 preserve this area, accurately, 181 00:10:16,560 --> 00:10:19,760 and rebuild this part at once. 182 00:10:19,920 --> 00:10:22,960 We'll take your left iliac crest. 183 00:10:23,120 --> 00:10:26,520 - OK? - Is it up here? 184 00:10:27,040 --> 00:10:28,040 Right 185 00:10:28,880 --> 00:10:30,760 here, this portion of the bone. 186 00:10:30,920 --> 00:10:33,160 The good thing with the iliac crest 187 00:10:33,440 --> 00:10:37,080 is that the shape of the crest, of the front part here, 188 00:10:37,240 --> 00:10:38,920 corresponds well, 189 00:10:39,080 --> 00:10:42,600 even though we'll need to adjust it during surgery, 190 00:10:42,760 --> 00:10:45,200 it matches quite well the angle of the jaw. 191 00:10:45,360 --> 00:10:47,200 It will recreate your contours. 192 00:10:47,360 --> 00:10:49,560 It's more... 193 00:10:50,080 --> 00:10:53,120 Did you know that hipbones were used to fix jaws 194 00:10:53,280 --> 00:10:54,520 before you needed it? 195 00:10:54,680 --> 00:10:56,000 I had no idea. 196 00:10:57,520 --> 00:10:59,160 It's hard to conceive 197 00:10:59,480 --> 00:11:02,840 that one bone can replace another. 198 00:11:03,000 --> 00:11:04,160 That's true. 199 00:11:04,320 --> 00:11:07,640 But you knew about bone grafting, didn't you? 200 00:11:07,800 --> 00:11:11,240 I did, but I thought a graft 201 00:11:11,400 --> 00:11:15,280 came from someone else's bones in 90 % of the cases. 202 00:11:15,440 --> 00:11:16,440 I see. 203 00:11:16,640 --> 00:11:20,040 Well, you see, an iliac crest... 204 00:11:20,240 --> 00:11:22,400 Time for a surgery lesson 205 00:11:23,920 --> 00:11:25,480 to reassure Mrs Brémaud. 206 00:11:26,800 --> 00:11:28,880 That's all. Any questions? 207 00:11:30,040 --> 00:11:32,920 Let me think. Any risk of failure? 208 00:11:33,120 --> 00:11:35,440 There is, as with any surgery. 209 00:11:39,040 --> 00:11:41,720 5 to 8 % in your particular case. 210 00:11:45,280 --> 00:11:46,280 Extra challenge: 211 00:11:46,840 --> 00:11:50,120 for the operation to succeed, Mrs Brémaud's face 212 00:11:50,320 --> 00:11:52,560 has to stay the same as today. 213 00:11:54,560 --> 00:11:58,400 Nowadays, that's a requirement for surgeons, 214 00:11:58,560 --> 00:12:01,280 as we're concerned about aesthetics. 215 00:12:01,440 --> 00:12:04,280 We want surgery to be as unobtrusive as possible, 216 00:12:04,440 --> 00:12:07,360 to keep the procedure from producing 217 00:12:09,160 --> 00:12:13,600 something of an additional defect 218 00:12:13,760 --> 00:12:15,920 or an additional disability. 219 00:12:16,080 --> 00:12:18,360 Our priority is to remove the tumor, 220 00:12:18,520 --> 00:12:20,360 then reconstruct the face, 221 00:12:20,520 --> 00:12:24,200 then keep surgery from producing, 222 00:12:24,360 --> 00:12:26,640 visible additional scars. 223 00:12:26,800 --> 00:12:28,760 We want discretion. 224 00:12:29,920 --> 00:12:31,240 The next morning, 225 00:12:32,320 --> 00:12:33,320 surgery begins. 226 00:12:35,720 --> 00:12:38,160 Take it out, careful. Let's not mess up. 227 00:12:38,840 --> 00:12:40,280 Can someone hold this? 228 00:12:42,440 --> 00:12:44,320 Bipolar forceps, please. 229 00:12:45,160 --> 00:12:46,360 Move the lip aside. 230 00:12:51,400 --> 00:12:52,520 Gently, 231 00:12:54,040 --> 00:12:56,000 and lovingly, as always. 232 00:12:58,000 --> 00:13:01,000 Feels like a forceps delivery, though. 233 00:13:02,560 --> 00:13:04,240 Here we go. Alright. 234 00:13:04,400 --> 00:13:09,360 You can see that the problem here... It's not very long, is it? 235 00:13:09,800 --> 00:13:11,880 And the problem is hidden inside. 236 00:13:12,040 --> 00:13:15,200 - It's quite big! - It's... Yeah. 237 00:13:15,360 --> 00:13:19,480 - That was her jaw? - Part of her lower jaw, yes. 238 00:13:21,680 --> 00:13:25,200 6 hours into the operation, the surgeons are extracting 239 00:13:25,400 --> 00:13:28,600 the hip bone meant to replace the lower jaw. 240 00:13:29,480 --> 00:13:32,960 If we, surgeons, found ourselves in this situation, 241 00:13:33,120 --> 00:13:35,360 what would we accept? 242 00:13:35,520 --> 00:13:39,000 Would we accept this for ourselves? That's the... 243 00:13:39,160 --> 00:13:42,000 To use a trendy word, 244 00:13:43,120 --> 00:13:44,360 the ethics. 245 00:13:46,240 --> 00:13:48,000 Would you accept it, then? 246 00:13:48,160 --> 00:13:50,960 Above all, I'd choose my surgeon. 247 00:13:53,120 --> 00:13:55,560 For the bone to live in the jaw, 248 00:13:55,720 --> 00:13:58,400 it is extracted with a vein and an artery 249 00:13:58,560 --> 00:14:00,280 that will be reconnected. 250 00:14:01,640 --> 00:14:03,840 It also has to be sculpted. 251 00:14:08,400 --> 00:14:11,840 A microscope is used to finish the operation 252 00:14:12,040 --> 00:14:13,880 and suture the vein. 253 00:14:14,040 --> 00:14:16,520 This is still pretty thick. 254 00:14:16,680 --> 00:14:20,920 The technical limit of what we can do, 255 00:14:21,120 --> 00:14:24,680 is to connect two vessels 256 00:14:25,920 --> 00:14:29,000 of about 0.8 mm in diameter, approximately. 257 00:14:29,160 --> 00:14:31,560 Anything smaller can't be done by hand. 258 00:14:32,160 --> 00:14:35,440 Last suture. The bone comes back to life in the jaw. 259 00:14:35,600 --> 00:14:38,040 Surgery is finished, Madam. It's all good. 260 00:14:38,440 --> 00:14:40,120 The operation is over. 261 00:14:42,360 --> 00:14:44,080 A few years ago, 262 00:14:44,440 --> 00:14:47,440 Mrs Brémaud's face would have been lost, 263 00:14:47,600 --> 00:14:48,800 forever scarred. 264 00:14:48,960 --> 00:14:52,360 Nowadays, facial reconstruction is planned in 3D. 265 00:14:52,520 --> 00:14:54,600 Software designed for aeronautics 266 00:14:55,640 --> 00:14:58,160 is used to anticipate the future of faces. 267 00:14:59,880 --> 00:15:01,840 Long gone are the days 268 00:15:02,120 --> 00:15:06,160 of the Great War's broken faces, for which surgeons of the time 269 00:15:06,320 --> 00:15:09,360 had to invent the first reconstruction techniques. 270 00:15:11,560 --> 00:15:13,960 All of today's pioneers 271 00:15:14,160 --> 00:15:15,800 are their heirs. 272 00:15:20,480 --> 00:15:23,320 Back to Henri Mondor Hospital, in Créteil, 273 00:15:24,240 --> 00:15:27,560 where a new face awakens. 274 00:15:29,440 --> 00:15:30,640 - OK? - It's great! 275 00:15:35,040 --> 00:15:38,080 I have my symmetry back. 276 00:15:39,440 --> 00:15:41,800 It'll be great once the swelling's gone. 277 00:15:47,240 --> 00:15:50,400 In this hospital, there are faces to discover, 278 00:15:50,560 --> 00:15:54,480 but others are already well known, like Pascal's. 279 00:15:56,640 --> 00:15:58,040 Pascal is here. 280 00:15:58,200 --> 00:15:59,400 - How are you? - Good. 281 00:16:01,240 --> 00:16:03,000 Pascal has had a face transplant. 282 00:16:03,440 --> 00:16:07,960 Only 3 people in the world live in someone else's skin. 283 00:16:08,120 --> 00:16:10,160 It'll be one year on the 21st. 284 00:16:10,480 --> 00:16:13,160 Right, it'll be one year on the 21st! 285 00:16:13,320 --> 00:16:15,520 Is Prof. Lantieri going to celebrate it? 286 00:16:15,680 --> 00:16:17,480 I don't know. I think so. 287 00:16:17,640 --> 00:16:19,480 You are going to celebrate, right? 288 00:16:21,920 --> 00:16:24,080 Pascal wants to say hi. 289 00:16:25,000 --> 00:16:27,520 - How are you? - Happy New Year! 290 00:16:27,680 --> 00:16:28,680 Same to you! 291 00:16:28,840 --> 00:16:30,640 Along with a new face, 292 00:16:30,800 --> 00:16:32,480 his whole life has changed, 293 00:16:32,760 --> 00:16:34,400 undreamed-of one year ago. 294 00:16:34,560 --> 00:16:37,240 A disease had completely disfigured him. 295 00:16:39,160 --> 00:16:41,440 - Take care. - Alright. 296 00:16:41,600 --> 00:16:44,120 - Bye. - See you, Pascal, bye! 297 00:16:45,960 --> 00:16:47,360 This touches you. 298 00:16:47,960 --> 00:16:51,280 It does, yes. It happens with some patients. 299 00:16:51,440 --> 00:16:53,680 When you see their evolution, 300 00:16:53,880 --> 00:16:56,720 and that it's all going well, 301 00:16:56,880 --> 00:17:00,080 it touches us a lot more. 302 00:17:00,240 --> 00:17:03,080 Each story is different. 303 00:17:03,240 --> 00:17:05,440 This one is beautiful. 304 00:17:06,840 --> 00:17:10,560 A beautiful story and a gamble for Pascal and his surgeon. 305 00:17:10,720 --> 00:17:14,160 The benefits are great, but so are the risks. 306 00:17:14,320 --> 00:17:15,400 From surgery 307 00:17:15,600 --> 00:17:19,560 to life treatment, Pascal's future will always be hazy. 308 00:17:19,720 --> 00:17:22,720 His disease isn't fatal, but trying something 309 00:17:24,600 --> 00:17:27,520 to get rid of it is life-threatening. 310 00:17:27,680 --> 00:17:31,360 What good is it to add years to your life 311 00:17:31,520 --> 00:17:34,000 if you can't add life to your years? 312 00:17:36,320 --> 00:17:40,200 What good is it to tell someone: "You can live with this", 313 00:17:40,360 --> 00:17:44,560 if they can't experience a normal human life? 314 00:17:44,720 --> 00:17:47,200 Communicating with others, 315 00:17:47,360 --> 00:17:50,200 marrying and having children, 316 00:17:50,360 --> 00:17:53,960 working, going out, traveling. 317 00:17:54,240 --> 00:17:56,840 - There are risks of cancer. - There are. 318 00:17:57,000 --> 00:17:59,400 There are risks of infection, yes. 319 00:17:59,560 --> 00:18:02,520 We're aware of that. We're taking that risk. 320 00:18:03,240 --> 00:18:08,640 Pascal knew it very well, too. We've informed him of everything. 321 00:18:08,800 --> 00:18:13,280 On the other hand, he's improved. He has a good life now. 322 00:18:13,800 --> 00:18:15,520 His treatment is light enough, 323 00:18:15,680 --> 00:18:18,640 to not interfere with his quality of life. 324 00:18:18,800 --> 00:18:23,400 Even though the transplant has shortened his life span? 325 00:18:23,560 --> 00:18:26,680 - It's still positive for him? - Yes. 326 00:18:27,840 --> 00:18:28,640 Yes. 327 00:18:29,880 --> 00:18:34,160 We may have cut a few years from his life, 328 00:18:35,120 --> 00:18:39,240 but we have given life to the years he has left. 329 00:18:42,800 --> 00:18:44,520 Who would risk their life 330 00:18:44,800 --> 00:18:45,880 for a new face? 331 00:18:47,320 --> 00:18:49,520 How do you decide to operate 332 00:18:49,720 --> 00:18:51,280 when risks are so high? 333 00:18:51,440 --> 00:18:53,080 - Hello. - Hello. 334 00:18:53,240 --> 00:18:54,760 - How are you? - Hello. 335 00:18:54,920 --> 00:18:56,000 Come in. 336 00:18:57,080 --> 00:19:00,160 Pascal's transplant has given Jérôme high hopes. 337 00:19:00,320 --> 00:19:04,320 They have the same disease: neurofibromatosis. 338 00:19:04,680 --> 00:19:06,200 Close your eyes, tightly. 339 00:19:07,160 --> 00:19:08,000 Release. 340 00:19:14,480 --> 00:19:17,160 The skin of people 341 00:19:17,440 --> 00:19:19,120 with neurofibromatosis 342 00:19:19,280 --> 00:19:20,840 is different. 343 00:19:21,000 --> 00:19:24,360 Normal skin is elastic. 344 00:19:24,520 --> 00:19:27,520 When you pull on it, it comes back. 345 00:19:27,680 --> 00:19:32,440 Studies we've conducted show that skin with neurofibromatosis 346 00:19:32,600 --> 00:19:34,040 reacts like chewing gum. 347 00:19:34,200 --> 00:19:36,600 When you pull on it, it stays. 348 00:19:36,960 --> 00:19:41,040 If we apply traction here, it will go down after a few months. 349 00:19:41,200 --> 00:19:44,960 We need to remove tissues where they're damaged the most. 350 00:19:45,160 --> 00:19:47,680 What kind of face can Jérôme hope for? 351 00:19:49,600 --> 00:19:51,960 The question is: "What can we hope for?" 352 00:19:52,120 --> 00:19:53,720 We hope to give him a face 353 00:19:53,880 --> 00:19:57,280 that allows him to blend in a crowd. 354 00:19:58,520 --> 00:20:00,240 What about you, Jérôme? 355 00:20:00,400 --> 00:20:04,480 Just like Prof. Lantieri said. 356 00:20:04,640 --> 00:20:05,960 I don't expect 357 00:20:06,720 --> 00:20:07,600 miracles, 358 00:20:07,760 --> 00:20:11,960 to look like Alain Delon or Georges Clooney. 359 00:20:12,120 --> 00:20:16,600 I just want an ordinary face 360 00:20:16,760 --> 00:20:19,880 to blend in a crowd. 361 00:20:23,120 --> 00:20:27,400 For months, the dermatologist and the surgeon have been speculating, 362 00:20:27,600 --> 00:20:31,040 researching, hesitating, consulting neurosurgeons. 363 00:20:31,200 --> 00:20:33,040 Jérôme's disease is very invasive, 364 00:20:33,920 --> 00:20:36,320 and surgery is risky. 365 00:20:36,480 --> 00:20:39,800 Last time, we talked about a possible operation. 366 00:20:40,000 --> 00:20:42,040 How many surgeries have you had? 367 00:20:42,200 --> 00:20:43,320 - About 15. - 15. 368 00:20:44,120 --> 00:20:46,760 I'm not here today to ask you 369 00:20:46,960 --> 00:20:49,640 for a transplant at all costs. 370 00:20:49,800 --> 00:20:52,720 If it can be avoided, that's fine. 371 00:20:52,920 --> 00:20:56,560 I don't want a transplant at all costs. 372 00:20:56,880 --> 00:21:00,840 It's up to the medical team to make the decision. 373 00:21:01,000 --> 00:21:04,800 - My goal isn't the transplant. - The decision is up to you. 374 00:21:05,000 --> 00:21:07,560 We explain the risks 375 00:21:07,760 --> 00:21:10,320 and the benefits to bear 376 00:21:10,480 --> 00:21:13,560 if you decide to go through with this operation. 377 00:21:13,720 --> 00:21:16,920 The transplant isn't our primary goal either. 378 00:21:17,080 --> 00:21:18,440 Our goal is improvement 379 00:21:18,720 --> 00:21:20,800 with as few risks as possible. 380 00:21:20,960 --> 00:21:22,120 There's something 381 00:21:22,320 --> 00:21:24,080 we haven't discussed yet. 382 00:21:24,240 --> 00:21:28,560 You haven't asked us about the risk of death during surgery. 383 00:21:28,720 --> 00:21:31,040 I don't ask myself that question, 384 00:21:31,240 --> 00:21:34,720 I suppose I shy away from it on purpose. 385 00:21:37,080 --> 00:21:38,760 It's a bit paradoxical. 386 00:21:38,920 --> 00:21:42,160 I wonder a lot about risks, 387 00:21:42,320 --> 00:21:44,440 but it's scary, 388 00:21:44,600 --> 00:21:48,880 so perhaps I don't dare ask questions. 389 00:21:49,400 --> 00:21:52,280 It's risky surgery, for sure. 390 00:21:52,440 --> 00:21:55,200 Plexiform neurofibroma such as yours 391 00:21:55,360 --> 00:21:58,960 is prone to heavy bleeding during surgery. 392 00:21:59,120 --> 00:22:01,280 It's the greatest risk for us. 393 00:22:01,560 --> 00:22:05,520 Most of the teams doing this or at least trying to do this, 394 00:22:05,680 --> 00:22:07,520 stop after the first gesture 395 00:22:07,680 --> 00:22:11,880 because they quickly feel overwhelmed by the hemorrhaging. 396 00:22:12,800 --> 00:22:15,400 Our experience allows us to move forward, 397 00:22:15,560 --> 00:22:17,520 but the risk is still here. 398 00:22:17,680 --> 00:22:19,520 See you for your hospitalization. 399 00:22:20,840 --> 00:22:24,880 No decision has been made, except for a medical checkup. 400 00:22:25,720 --> 00:22:28,160 They're all taking time to think about it. 401 00:22:30,360 --> 00:22:32,080 Of course, we're scared. 402 00:22:32,600 --> 00:22:36,840 Our responsibility is not only forensic or legal. 403 00:22:37,000 --> 00:22:39,880 The problem is, our purpose is to heal people. 404 00:22:40,040 --> 00:22:41,960 So we're scared to take risks. 405 00:22:42,120 --> 00:22:45,200 We take them because at one point, 406 00:22:45,360 --> 00:22:48,520 our conscience tells us we can improve the patient, 407 00:22:48,680 --> 00:22:52,360 and because the patient accepts this improvement, 408 00:22:52,560 --> 00:22:54,840 knowing there's this potential risk. 409 00:22:55,000 --> 00:22:57,560 We're not reckless, though. 410 00:22:57,720 --> 00:23:01,400 If we go through with it, it means that we can manage the risk, 411 00:23:01,560 --> 00:23:05,000 and that it won't lead the patient 412 00:23:06,160 --> 00:23:07,200 to death. 413 00:23:07,360 --> 00:23:10,240 Otherwise we'd be mad to suggest surgery. 414 00:23:10,720 --> 00:23:12,640 It must be mind-blowing. 415 00:23:13,360 --> 00:23:14,840 It is. 416 00:23:15,040 --> 00:23:18,080 It's true. And it's the reason we work as a team. 417 00:23:18,600 --> 00:23:20,680 If I was alone with a patient, 418 00:23:20,880 --> 00:23:23,960 deciding what to do, without knowing all the facts, 419 00:23:24,120 --> 00:23:27,840 without a whole team, it would be impossible. 420 00:23:28,040 --> 00:23:30,440 It keeps us up at night. 421 00:23:30,600 --> 00:23:31,720 It does, at times. 422 00:23:35,000 --> 00:23:37,680 It isn't mind-blowing. 423 00:23:37,840 --> 00:23:40,600 It's just the thick of life and death issues. 424 00:23:40,760 --> 00:23:44,680 There's nothing subtle about it. We're right in the... 425 00:23:44,840 --> 00:23:46,760 It's about scary decisions. 426 00:23:46,920 --> 00:23:48,840 It's beyond mind-blowing. 427 00:23:52,000 --> 00:23:53,280 Medical research 428 00:23:53,480 --> 00:23:55,760 is likely to deny them more sleep. 429 00:23:56,480 --> 00:23:58,040 That day, 430 00:23:58,200 --> 00:24:00,800 one of their young patients has been rushed in. 431 00:24:03,320 --> 00:24:05,080 When was the accident again? 432 00:24:06,320 --> 00:24:07,560 November 2004. 433 00:24:07,720 --> 00:24:08,920 November 2004. 434 00:24:10,440 --> 00:24:12,240 When did the eyes get worse? 435 00:24:12,400 --> 00:24:14,320 - Fifteen days ago? - Yes. 436 00:24:14,920 --> 00:24:17,640 He was badly burnt and completely disfigured. 437 00:24:18,640 --> 00:24:21,160 Surgeons shut his eyelids to protect his eyes. 438 00:24:21,440 --> 00:24:23,960 I'm going to reopen the right eye 439 00:24:24,120 --> 00:24:26,640 which we had closed gradually over time, 440 00:24:26,800 --> 00:24:28,960 so we can examine it correctly 441 00:24:29,120 --> 00:24:31,520 and treat it properly. 442 00:24:34,400 --> 00:24:36,320 What can you do for him? 443 00:24:37,840 --> 00:24:40,800 What can medicine do for him? What can we do? 444 00:24:40,960 --> 00:24:43,360 We can try to help him for now. 445 00:24:43,520 --> 00:24:46,920 Sadly, there's no solution for this kind of lesion. 446 00:24:47,080 --> 00:24:49,320 He's had a lot of surgery already. 447 00:24:50,000 --> 00:24:52,520 A transplant would be the only solution. 448 00:24:52,680 --> 00:24:55,680 The problem is, so far no surgeon has found 449 00:24:55,880 --> 00:24:58,600 how to graft fully functional eyelids. 450 00:24:58,760 --> 00:25:02,040 It's all about working and designing solutions. 451 00:25:02,200 --> 00:25:03,400 It's about research. 452 00:25:03,560 --> 00:25:04,840 It has been shown 453 00:25:05,000 --> 00:25:07,600 that there are solutions for the lower part. 454 00:25:07,760 --> 00:25:10,800 It means we can find solutions for the upper part, 455 00:25:10,960 --> 00:25:12,440 but it's a lot harder. 456 00:25:13,720 --> 00:25:15,720 Until a potential transplant... 457 00:25:15,880 --> 00:25:17,200 Monocryl, please. 458 00:25:17,400 --> 00:25:21,880 ...this young man is doomed to a life with no face and no vision. 459 00:25:22,080 --> 00:25:23,160 He is 27. 460 00:25:30,720 --> 00:25:34,200 - You got candy? - In my house. 461 00:25:34,360 --> 00:25:37,080 So you didn't bring any candy at all with you? 462 00:25:37,240 --> 00:25:40,120 - What did you bring with you? - Nothing. 463 00:25:40,280 --> 00:25:41,120 Nothing? 464 00:25:41,320 --> 00:25:44,840 Miles away from the concerns of medical research, 465 00:25:45,000 --> 00:25:46,840 at Armand-Trousseau, Paris, 466 00:25:47,000 --> 00:25:50,040 other questions puzzle younger patients. 467 00:25:50,680 --> 00:25:51,600 - Billy? - No. 468 00:25:51,760 --> 00:25:53,080 - Frank? Harry? - No. 469 00:25:53,240 --> 00:25:55,200 Rémy? Jacques? 470 00:25:55,360 --> 00:25:56,520 Is your name 471 00:25:57,400 --> 00:25:58,920 - Paul-Émile? - Yes. 472 00:25:59,600 --> 00:26:01,400 Found it! Awesome! 473 00:26:01,560 --> 00:26:04,160 I'm so happy, I'm so smart. 474 00:26:07,240 --> 00:26:10,640 Whether because of a malformation, accident or dog bite, 475 00:26:10,840 --> 00:26:12,680 reconstructing faces 476 00:26:12,960 --> 00:26:14,280 starts very early. 477 00:26:15,760 --> 00:26:18,480 Here, surgeons challenge ill-fortune 478 00:26:18,640 --> 00:26:20,200 and change children's future. 479 00:26:21,640 --> 00:26:24,200 Going back to school, making friends, 480 00:26:24,360 --> 00:26:25,800 stopping the taunts. 481 00:26:27,720 --> 00:26:29,360 Reconstructing their face 482 00:26:29,800 --> 00:26:31,960 to help them build a full life. 483 00:26:34,640 --> 00:26:36,640 It was a week ago. 484 00:26:36,880 --> 00:26:38,480 Then you look like this. 485 00:26:40,840 --> 00:26:42,680 Tomorrow we'll remove all that, 486 00:26:42,840 --> 00:26:45,200 inside the nose and on the nose. 487 00:26:45,960 --> 00:26:48,400 In the operating room, 5-month-old Loa 488 00:26:48,680 --> 00:26:50,400 is about to get a new face. 489 00:26:50,800 --> 00:26:51,960 She was born 490 00:26:52,160 --> 00:26:54,560 with a cleft lip that impairs her smile. 491 00:26:55,720 --> 00:26:58,680 Farther, time is of the essence for David. 492 00:26:58,880 --> 00:27:01,520 He's 3 and his tracheotomy ostracizes him. 493 00:27:02,400 --> 00:27:05,480 He can't breathe or talk like other children. 494 00:27:08,720 --> 00:27:12,440 Surgeons are going to try and free him from his cannula. 495 00:27:12,600 --> 00:27:13,760 To do so, 496 00:27:13,960 --> 00:27:15,680 they have to redesign his face 497 00:27:15,840 --> 00:27:17,680 and extend his entire lower jaw. 498 00:27:20,000 --> 00:27:21,600 During the operation, 499 00:27:21,760 --> 00:27:23,880 the surgeons will cut the bone on both sides 500 00:27:25,240 --> 00:27:26,680 and spread the fracture 501 00:27:26,880 --> 00:27:29,880 by 1 mm a day with custom-made devices, 502 00:27:31,000 --> 00:27:32,680 called distractors. 503 00:27:34,160 --> 00:27:36,720 Within that space, new bone 504 00:27:36,920 --> 00:27:38,800 will grow naturally. 505 00:27:39,920 --> 00:27:42,760 You're using the natural workings of the human body. 506 00:27:42,920 --> 00:27:45,720 We are. It's regenerative surgery. 507 00:27:45,920 --> 00:27:48,720 We call on the person's healing abilities. 508 00:27:48,880 --> 00:27:52,640 The child, thanks to his natural healing abilities, 509 00:27:52,800 --> 00:27:55,400 is conditioned to grow a new bone 510 00:27:55,560 --> 00:27:56,800 where we choose. 511 00:27:58,280 --> 00:27:59,440 Two weeks later, 512 00:27:59,600 --> 00:28:01,600 David's jaw bones 513 00:28:01,800 --> 00:28:03,680 will have grown by about 2 cm. 514 00:28:07,160 --> 00:28:08,720 In the next room, 515 00:28:08,920 --> 00:28:11,520 reconstructing Loa's face is precision work. 516 00:28:11,920 --> 00:28:13,960 The surgical site is less than 10 mm². 517 00:28:16,480 --> 00:28:20,480 We're suturing the lip's muscles. 518 00:28:20,960 --> 00:28:23,560 They're used in facial expressions, smiles, 519 00:28:24,160 --> 00:28:25,520 for the lip function. 520 00:28:26,760 --> 00:28:29,320 Despite appearances, all elements of the face 521 00:28:29,520 --> 00:28:31,440 are there from the birth: 522 00:28:31,680 --> 00:28:33,440 the nose, lips and palate. 523 00:28:34,480 --> 00:28:36,600 The surgeon assembles them, 524 00:28:36,760 --> 00:28:38,880 just like they would have in the womb. 525 00:28:39,760 --> 00:28:42,440 But there's an additional issue: 526 00:28:42,600 --> 00:28:44,200 any error will grow 527 00:28:44,480 --> 00:28:45,880 with the child. 528 00:28:50,120 --> 00:28:54,360 If the outline of the lip is flawed, 529 00:28:54,520 --> 00:28:56,000 by, let's say, 0.2 mm, 530 00:28:56,160 --> 00:28:59,760 when the child is 4, it will amount to 1 or 2 mm. 531 00:28:59,920 --> 00:29:01,640 It'll be much more visible. 532 00:29:01,800 --> 00:29:04,600 Flaws aren't always visible in infants. 533 00:29:04,760 --> 00:29:07,400 They show when the child grows. 534 00:29:08,480 --> 00:29:11,160 Self-image starts from the birth. 535 00:29:11,320 --> 00:29:13,440 If Loa hadn't been operated on, 536 00:29:13,600 --> 00:29:14,800 this difference 537 00:29:15,000 --> 00:29:17,240 could have been hard to live with, 538 00:29:17,400 --> 00:29:19,040 as early as kindergarten. 539 00:29:20,440 --> 00:29:22,600 We know that around 4 or 5, 540 00:29:22,800 --> 00:29:25,720 the child can point out his disgrace. 541 00:29:25,880 --> 00:29:28,520 As a consequence, 542 00:29:29,640 --> 00:29:33,320 there can be a permanent negative impact on his self-image. 543 00:29:33,480 --> 00:29:36,640 That's why now, in pediatric plastic surgery, 544 00:29:36,800 --> 00:29:39,120 we tend to operate earlier and earlier, 545 00:29:40,640 --> 00:29:43,880 especially before first grade, 546 00:29:44,040 --> 00:29:47,440 to avoid these self-image issues 547 00:29:47,600 --> 00:29:49,680 that would persist as time goes by. 548 00:29:58,360 --> 00:30:01,160 In the recovery room, 549 00:30:01,360 --> 00:30:03,560 the children's new faces awaken. 550 00:30:15,000 --> 00:30:16,560 The road ahead is long. 551 00:30:16,760 --> 00:30:18,880 Loa will be monitored until she is 18. 552 00:30:19,040 --> 00:30:20,560 She'll have more surgery. 553 00:30:21,440 --> 00:30:24,360 This is just the beginning for David's 554 00:30:24,560 --> 00:30:26,120 facial reconstruction. 555 00:30:33,600 --> 00:30:36,520 Children's surgery is very different from adults'. 556 00:30:37,760 --> 00:30:40,720 Modifying a face can take 18 years. 557 00:30:42,560 --> 00:30:45,360 The surgeons meet that evening. 558 00:30:45,960 --> 00:30:48,760 A young Kuwaiti has just arrived in France. 559 00:30:49,000 --> 00:30:52,920 His parents will do anything for him to have a normal face. 560 00:30:53,080 --> 00:30:54,840 The child, Abdel-Rahman, 561 00:30:55,040 --> 00:30:58,600 is 10 and suffers from Goldenhar syndrome. 562 00:30:58,960 --> 00:31:00,840 He is from Kuwait. 563 00:31:01,000 --> 00:31:03,720 He's had many operations, 564 00:31:03,880 --> 00:31:05,680 most notably in Australia, 565 00:31:05,880 --> 00:31:07,000 and in London. 566 00:31:07,160 --> 00:31:08,920 We have, at the same time, 567 00:31:09,120 --> 00:31:12,000 a cleft up to the orbit, 568 00:31:12,160 --> 00:31:15,520 and bones missing from this side 569 00:31:15,720 --> 00:31:16,920 of the face. 570 00:31:17,080 --> 00:31:19,720 What's more, they're coming from Kuwait. 571 00:31:20,720 --> 00:31:23,840 This kind of patient only comes once. 572 00:31:24,000 --> 00:31:27,440 A second trip is difficult for them. 573 00:31:27,840 --> 00:31:30,520 We need to plan the whole procedure now, 574 00:31:30,720 --> 00:31:32,920 even if we don't do it all at once. 575 00:31:33,120 --> 00:31:35,240 What does "all" mean for them? 576 00:31:35,440 --> 00:31:38,240 - They want him... - To bring the jaw forward. 577 00:31:38,440 --> 00:31:40,800 - They want a symmetrical face. - Almost. 578 00:31:40,960 --> 00:31:44,960 He's quite precise about it. His parents want the same as him. 579 00:31:45,120 --> 00:31:47,520 He points to his withdrawn lip 580 00:31:47,720 --> 00:31:49,120 and his eyelid. 581 00:31:49,280 --> 00:31:50,280 He wants that. 582 00:31:50,480 --> 00:31:52,000 All at once? 583 00:31:52,200 --> 00:31:55,280 It's unreasonable and unfeasible. 584 00:31:57,880 --> 00:32:01,360 How do you address expectant or desperate parents? 585 00:32:02,240 --> 00:32:06,560 The surgeons don't want to rush surgery. It could worsen the situation. 586 00:32:07,000 --> 00:32:10,320 We could bring the left upper maxillary forward, 587 00:32:10,480 --> 00:32:12,720 "the good side", as you said. 588 00:32:12,880 --> 00:32:16,240 We can do it in three weeks, then we can graft. 589 00:32:16,440 --> 00:32:19,480 After that, you can 590 00:32:19,680 --> 00:32:22,080 draw the lower eyelid up. 591 00:32:22,280 --> 00:32:26,160 This way, we can at least fulfill the child's requests, 592 00:32:27,160 --> 00:32:28,680 within 4 to 5 months. 593 00:32:31,160 --> 00:32:33,080 We need a minimum of 6 months. 594 00:32:33,280 --> 00:32:35,880 If we lay out a surgical planning, 595 00:32:36,040 --> 00:32:40,080 I'm sure the parents will accept it, even if they need to come back. 596 00:32:42,480 --> 00:32:44,280 A few days later, 597 00:32:44,480 --> 00:32:46,840 the family meets the medical team. 598 00:32:48,720 --> 00:32:51,320 An interpreter accompanies them. 599 00:32:53,200 --> 00:32:55,160 Can they understand and accept 600 00:32:55,320 --> 00:32:58,360 that the surgeons can't fully meet their request? 601 00:33:01,320 --> 00:33:03,560 The way we see it, the priority 602 00:33:03,760 --> 00:33:06,480 is to rebuild bone areas, in several steps. 603 00:33:06,960 --> 00:33:10,600 We're going to try and shorten intervals between steps 604 00:33:10,760 --> 00:33:11,960 as you live far away. 605 00:33:12,240 --> 00:33:13,400 And move forward... 606 00:33:13,560 --> 00:33:16,280 The first operation could happen 3 weeks later. 607 00:33:17,320 --> 00:33:20,840 The parents seem to understand that it's going to take time. 608 00:33:21,280 --> 00:33:23,040 ... the upper jaw. 609 00:33:24,600 --> 00:33:28,280 How many millimetres will you bring the jaw forward? 610 00:33:28,480 --> 00:33:32,000 In my opinion, we can easily bring it forward 611 00:33:32,200 --> 00:33:34,480 by 1.5 cm. 612 00:33:35,400 --> 00:33:38,200 - More. - 1.5 cm is a minimum. 613 00:33:39,400 --> 00:33:42,520 The little boy wants to ask something. 614 00:33:43,840 --> 00:33:45,920 Will he be able to play football? 615 00:33:46,120 --> 00:33:47,960 That's a tricky one. 616 00:33:48,120 --> 00:33:50,600 It's a bit dangerous, you know? 617 00:33:51,080 --> 00:33:52,080 Football is a no. 618 00:33:52,240 --> 00:33:56,480 It's best not to play for at least one or two months. 619 00:33:56,640 --> 00:33:59,640 Best to avoid contact sports, 620 00:33:59,800 --> 00:34:02,080 sports where collisions can happen. 621 00:34:03,880 --> 00:34:05,960 By the end of the appointment, 622 00:34:06,120 --> 00:34:08,960 the family agrees to step-by-step surgery: 623 00:34:09,120 --> 00:34:12,760 4 to 5 major interventions within a year. 624 00:34:13,800 --> 00:34:14,920 My parents agree. 625 00:34:16,200 --> 00:34:18,800 What about you? Do you agree with it? 626 00:34:20,600 --> 00:34:21,600 Sure, I do. 627 00:34:22,880 --> 00:34:24,800 I want to look more beautiful 628 00:34:24,960 --> 00:34:27,200 because my friends always stare at me. 629 00:34:28,880 --> 00:34:30,080 I don't like it. 630 00:34:31,160 --> 00:34:34,440 Will you do anything for your son to have a normal face? 631 00:34:35,720 --> 00:34:36,840 Yes, of course. 632 00:34:38,640 --> 00:34:40,560 I have 2 daughters and only one son. 633 00:34:40,720 --> 00:34:43,680 I'll do anything to fix what can be fixed. 634 00:34:44,600 --> 00:34:47,160 Even if it means a lot of surgery? 635 00:34:49,760 --> 00:34:53,400 Yes, but I don't think of it as a sacrifice. 636 00:34:53,560 --> 00:34:55,400 He's hurting, not me. 637 00:34:55,600 --> 00:34:58,120 He's suffering. 638 00:34:58,280 --> 00:35:00,600 Of course, I'll do anything. 639 00:35:02,080 --> 00:35:05,160 It's okay if it takes time. It's up to the doctor. 640 00:35:05,320 --> 00:35:07,400 He knows better than we do. 641 00:35:07,560 --> 00:35:12,240 A month, a year, two or three years, I'm ready to wait. 642 00:35:12,400 --> 00:35:15,760 All that matters is that my son gets a normal face. 643 00:35:20,040 --> 00:35:24,800 The Embassy of Kuwait is going to pay for the child's stay in hospital. 644 00:35:25,000 --> 00:35:28,440 But his father won't be able to work during that time. 645 00:35:33,800 --> 00:35:37,080 Two weeks after his consultation, we went to see Jérôme, 646 00:35:37,240 --> 00:35:38,960 Professor Lantieri's patient. 647 00:35:40,040 --> 00:35:43,160 His mother and aunt have just arrived in Paris. 648 00:35:46,280 --> 00:35:49,600 For the first time, they've come to support him 649 00:35:49,760 --> 00:35:51,200 and discuss his decision 650 00:35:51,400 --> 00:35:52,920 about the surgery. 651 00:35:55,160 --> 00:35:57,200 Are we going to toast or not? 652 00:35:58,840 --> 00:36:02,040 Last time I saw him, we talked about surgical risks, 653 00:36:02,200 --> 00:36:03,920 such as hemorrhages. 654 00:36:04,080 --> 00:36:06,480 Prof. Wolkenstein talked about 655 00:36:08,240 --> 00:36:09,240 death, actually. 656 00:36:09,400 --> 00:36:12,680 He asked if I've ever thought about it. 657 00:36:12,840 --> 00:36:15,640 When you hear the doctor talking about that, 658 00:36:15,800 --> 00:36:19,760 you realise that indeed, there's a risk. 659 00:36:20,320 --> 00:36:22,200 The difficult thing is, 660 00:36:22,360 --> 00:36:25,680 - the final decision is up to me only. - Sure! 661 00:36:25,840 --> 00:36:27,160 Some people say: 662 00:36:27,360 --> 00:36:29,480 "You're right to do it." 663 00:36:29,640 --> 00:36:32,520 It's important to know what others think of it. 664 00:36:33,520 --> 00:36:36,720 Now, I'm facing this and wondering: 665 00:36:36,880 --> 00:36:38,880 "Shall I do it or not?" 666 00:36:40,520 --> 00:36:44,040 For years, Jérôme's face was taboo. 667 00:36:44,200 --> 00:36:47,680 Nobody around him talked about it for fear of hurting him, 668 00:36:47,840 --> 00:36:49,960 but he's always accepted his own story, 669 00:36:50,160 --> 00:36:52,480 and the silence that surrounded it. 670 00:36:53,080 --> 00:36:54,920 It was very painful. 671 00:36:55,080 --> 00:36:57,360 It was very painful to talk about it. 672 00:36:58,560 --> 00:37:01,320 I think there was some sort of guilt. 673 00:37:02,840 --> 00:37:04,920 Some sort of guilt. 674 00:37:05,080 --> 00:37:06,440 You ask yourself: "Why?" 675 00:37:06,600 --> 00:37:08,040 I used to wonder: "Why?" 676 00:37:09,120 --> 00:37:13,440 Are you ready for your son to take risks to have a new face? 677 00:37:13,640 --> 00:37:16,120 Yes. For him to have a better life. 678 00:37:16,280 --> 00:37:18,960 I've seen him go through such depression, 679 00:37:19,680 --> 00:37:21,880 calling me five times a day. 680 00:37:22,040 --> 00:37:24,920 I live 500 km away, so I imagine things. 681 00:37:31,160 --> 00:37:33,120 I want him to be happy. 682 00:37:33,280 --> 00:37:36,440 I know he won't be as long as he lives with this. 683 00:37:47,400 --> 00:37:48,600 That evening, 684 00:37:48,760 --> 00:37:51,560 Jérôme seemed determined to have surgery. 685 00:37:53,120 --> 00:37:56,360 Will he find the life he longs for behind his face? 686 00:37:57,560 --> 00:38:00,520 People giving him other looks? Other mirrors? 687 00:38:01,920 --> 00:38:05,800 The proof, in his appearance, that he's just like everybody else? 688 00:38:07,200 --> 00:38:10,080 Subtitles: T. Close-Koenig, E. Fuchs & N. Guechi