Can DNA Help to Improve Plastic Surgery Outcomes?

Researchers from Belgium and the United States have recently discovered 15 genes that help determine the features of the face.

The findings of the study, conducted by the KU Leuven, a research university in Belgium, and the universities of Pittsburgh, Stanford and Penn State, were published in Nature Genetics.

Genes determine appearance, and identifying the genes behind facial features could yield significant benefits such as allowing sketch artists to recreate the image of a perpetrator from DNA collected at a crime scene or allowing historians to restore facial features using ancient DNA.

Another potential application for the research is to complete skull and facial reconstruction of individuals who have suffered an injury or disfigurement from an accident.

Earlier research studies aimed at identifying the genes behind the components of the face first looked at specific features such as the distance between the eyes or the width of the nose and then worked backward to identify the genes that caused each feature.

They would then look for a connection between this feature and many genes. While this did help to identify some of the genes responsible for facial features, the results were limited because only a few features were examined.

During the current study, researchers chose a different methodology; they did not focus on any trait.

Using a collection of 3D facial images and DNA profiles of the individuals’ pictures, the researchers divided each face into smaller areas. The scientists then looked for matches from the DNA to areas in the face. This method allowed researchers to check for a multitude of facial features and find 15 locations in the DNA that corresponded to areas of the face.

One of these areas of the DNA controls how different genetic variants show up and how many of the genes get expressed.

Seven of the 15 identified genes were related to the nose. Identifying so many genes connected to the formation of the nose is an important discovery because the majority of the nose is soft tissue and cartilage, which makes reconstruction difficult.

“Reconstructing a nose or ear is more difficult than a chin or cheekbone because they are made of soft tissue, and if that tissue is missing, it can be difficult to reconstruct its original appearance,” said Dr. Gregory W. Chernoff, F.R.C.S.

There were 218,924 nose-reshaping procedures performed in the U.S. in 2017, according to the American Society of Plastic Surgeons.

The ability to see how an individual’s DNA is expressed to form the nose would allow surgeons like Chernoff to recreate the patient’s new nose as close to the original as possible.
Chernoff is a triple-board-certified facial, plastic and reconstructive surgeon with practices in Indianapolis, Indiana.

Plastic surgeons like Chernoff often perform reconstructive surgery procedures to treat patients who have experienced congenital disabilities, developmental abnormalities, trauma, infection, tumors or diseases.

“Plastic surgery is not solely about improving aesthetics. In many cases it is about repairing damaged tissues to restore function,” Chernoff said.

One of the facial areas often reconstructed is, in fact, the nose.

“Nasal fractures are the most common facial injury and often require surgery, as do deviated septums,” Chernoff said.

A deviated septum happens in the nose when the thin wall known as the nasal septum between your nasal passages becomes displaced to one side. A deviated septum can be genetic or can occur because of an injury. When a deviated septum becomes severe, it can block one side of the nose and reduce airflow, causing difficulty breathing and sleeping.

“Some patients also require nasal reconstruction after severe burns or because of an earlier rhinoplasty procedure that failed,” Chernoff said.

ASPS. Plastic Surgery Statistics 2018.
KU Leuven. “Fifteen new genes identified that shape our face.” ScienceDaily. ScienceDaily, 19 February 2018.