First face transplant performed on French woman

Thursday, December 1, 2005

Surgeons in France have performed a face transplant operation on a French woman who had lost her nose, lips and chin after being savaged by a dog. According to Iain Hutchison, an oral-facial surgeon at Barts and the London Hospital, the transplant is the first one to use skin from another person.

Doctors say the woman’s new face will be a “hybrid” between her donor’s face and her own face before the attack. In the five hour long operation, the donor’s tissues, muscles, arteries and veins were attached to the patient’s lower face. It is more favourable to use skin from another person’s face instead of skin from another part of the patient’s body, as the texture and colour of the skin are more likely to match.

A statement released by the hospital in Amiens said that the 38-year-old patient, who wishes to remain anonymous, has not been able to eat or speak properly since the attack in May this year. The woman was reportedly in “excellent general health” and her graft looked normal.

Ethical concerns, psychological impact, concerns relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Hutchison warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon’s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”