Surgeons carry out first face transplant

Paris: French surgeons have carried out the world’s first face transplant in a controversial medical breakthough.

It was carried out in France on a 36-year-old woman who lost her nose, lips and chin when she was savaged by a dog.

Doctors replaced the central triangle of her face with tissue taken from a donor’s face.

The woman has survived the critical first 48 hours without rejecting the transplant but is still in intensive care. Some experts put the risk of rejection of facial tissue as high as 50 per cent within five to 10 years.

The operation will intensify the ethical and moral debate which has surrounded research into face transplants.

Four teams around the world have been working towards this point but efforts in the UK effectively stalled in 2003 when the Royal College of Surgeons called for more research, saying the psychological impact of failure would be ‘immense’.

The ultimate goal of the pioneers is to replace an entire face.

The operation, believed to have taken around ten hours, was carried out on Sunday and Monday in the northern town of Amiens.

The team was headed by Jean-Michel Dubernard, who carried out the first hand transplant in 1998.

The surgeons worked through the night to remove the facial skin, fat and some blood vessels from a donor in Lille who had been declared brain dead. Permission had been granted by relatives.

The team then placed the graft over the recipient’s face before using microsurgical techniques to connect the tissues. Donated material is superior to skin grafts taken from the patient because facial skin is so different from tissue elsewhere in the body, such as the thigh, as it is finer with a slimmer layer of underlying fat.

The woman, from the northern town of Valenciennes, was disfigured by a dog bite in May and it is believed she had undergone counselling to prepare her for a possible transplant.

The donor will have been matched for facial colouring and skin texture, but the recipient will not take on her appearance because underlying bone structure forms such an important part of an individual’s appearance.

The medical team will be monitoring the patient for signs of rejection. If there are serious complications the tissue will have to be removed.

Even if the operation is a success she will have to take drugs for life to suppress her immune system. These drugs heighten the risk of cancer.

A source at the hospital said ‘The team were very excited after the operation. It is a world first which has massive implications for many badly disfigured people around the world.’