In a whim director John Woo lets main character Sean Archer switch looks with his antagonist Castor Troy in the popular movie Face/Off from the nineties. Secretly in a hyper advanced medical facility a method has been developed to achieve ultimate face lifts, that of taking on another face literally. Why settle with improving your face contours when you may get yourself completely new ones? But how realistic was the movie really, and what are the medical limitations with cosmetic plastic surgery?



The human organism could be said to automatically resist change. We are built to keep our weight, keep our skin barrier complete, to eradicate invading germs and to keep a balanced temperature even though the surroundings change. These are limitations which never bothered Mr. Woo in his sleep with. But as soon as your cosmetic face lift surgeon even breaks the stratum corneum of your skin (the outermost layer) he must consider many such factors.

All three levels constituting the skin - epidermis, dermis and subcutis - are detached from Nicolas Cage's skull in one single piece. This leaves his character Sean Archer with his facial bones basically only covered with deeper vessels, fascia and muscle layers. His face is then lifted off and replaced with another man's. To achieve the highest level of completion and to really make the new face fit snuggly, Archer's facial bones are re-sculpted.

Let us direct our attention to these techniques in reversed order. Cosmetically changing your facial bones to achieve a new look can be done, however as most of us know it is often easier to remove than to add. When adding to your face your plastic surgeon has to use material from your own body. Bone pieces from your pelvis may be used to enhance your nose or to give your cheeks another angle. This is because your body will resist tissue not recognized as your own. This makes it very hard to do any larger changes, as there really aren't any fabricated materials your body readily would accept.

This brings us to the next part, that of attaching a larger piece of another human onto yourself. Pick 100 strangers from the street and none of them would suit as donators for this facelift switch extraordinaire. Even if you chose your own sister you would have to be treated with massive amounts of immunosuppressant for the rest of your life. This is one of the reasons to why it is so hard to find for example kidney donors - two different body systems never ever match completely and most of the times really not at all. This to some extent even goes for identical twins!

So what would happen to Johan Travolta and Nicolas Cage placed under the knife of a real world cosmetic surgery face lift surgeon? Their new skin grafted faces would literally be eaten by their own internal defenses. And where does that leave us? Could cosmetic facelifts as these never be achieved? Well as always time will tell, but we would be in need of a completely new series of immune system modulators to begin with. Not to mention surgical precision at a new level.

Until we meet again, let me give you some advice. As goes with make-up, let face lift cosmetics enhance and improve your looks, but not totally change them. With the newly acquired knowledge from this article - what do you really think happened to Michael Jackson's face?