World's first face transplant
13 December 2005
French surgeons have hit the headlines with news that they've performed the world's first partial face transplant. How did they do it? And could the UK soon see similar operations?
Antenna took your questions to Britain's leading expert.
Image: CHU de Lyon
The story so far...
The medical team's patient was a 38-year-old woman who had been mauled by her dog. She had lost her lips, chin and part of her nose in the attack.
The medical team's patient was a 38-year-old woman who had been mauled by her dog. She had lost her lips, chin and part of her nose in the attack.
The patient's injuries were so severe that surgeons said a face transplant was the only answer - conventional plastic surgery wouldn't restore her ability to chew food properly or talk clearly.
Surgeons get to work on the world's first ever face transplant operation.
Image: CHU de Lyon
Eight surgeons completed the pioneering procedure during a 15-hour operation on Sunday 27 November 2005. They repaired their patient's face using a triangle of facial tissue carefully harvested from a multi-organ donor.
The graft included muscles, cartilage, skin, blood vessels and nerves. First the surgeons sewed together the donor and patient's blood vessels, then they connected up the nerves and muscles, before finally stitching the skin into place.
This is a reconstruction of the transplanted lips, nose and chin. Arteries are in red, veins are in blue, nerves are yellow and muscles are dark red.
Image: CHU de Lyon
The patient regained consciousness a day after her operation and her surgeons say she is doing well.
Peter Butler, plastic surgeon and face transplant expert, Royal Free Hospital.
Antenna asked you what you wanted to know about face transplants then took your questions to Peter Butler - the UK's leading face transplant expert. He hopes to carry out a full face transplant operation at the Royal Free Hospital, London. |
Your question:
Will the woman who has received the transplant regain full feeling in her face?
Will the woman who has received the transplant regain full feeling in her face?
Peter's answer:
'The patient's facial feeling depends on sensory nerves called the "mental" nerves which the French surgeons transplanted with the facial tissue. In trauma cases, there's a 60 per cent recovery rate for these nerves. The anti-rejection drugs that the patient is taking could improve this further.'
'The patient's facial feeling depends on sensory nerves called the "mental" nerves which the French surgeons transplanted with the facial tissue. In trauma cases, there's a 60 per cent recovery rate for these nerves. The anti-rejection drugs that the patient is taking could improve this further.'
Nerve fibres can recover, at least partially, after a transplant operation.
Your question:
Is it likely that the transplant will be rejected - and what would they do then?
Is it likely that the transplant will be rejected - and what would they do then?
Peter's answer:
'Rejection is possible at any time even though the surgeons check the patient and donor are compatible. "Acute" rejection can be treated successfully with drugs, but "chronic" rejection might happen up to 15 years later, and can't be treated.
'Rejection is possible at any time even though the surgeons check the patient and donor are compatible. "Acute" rejection can be treated successfully with drugs, but "chronic" rejection might happen up to 15 years later, and can't be treated.
'For this woman, if the transplant failed, a retransplant would be the best choice for her. Reconstruction would have limited success because of the missing area of her face.'
Your question:
Is the face transplant surgery similar to the hand transplants that have taken place?
Is the face transplant surgery similar to the hand transplants that have taken place?
Peter's answer:
'Yes - hands and faces are very similar in terms of their make-up (skin, muscle and bone) and immune response. Surgeons have now done 24 hand transplant operations, and all the acute rejections responded to anti-rejection drugs. They have experienced a higher success rate than kidney transplants.'
'Yes - hands and faces are very similar in terms of their make-up (skin, muscle and bone) and immune response. Surgeons have now done 24 hand transplant operations, and all the acute rejections responded to anti-rejection drugs. They have experienced a higher success rate than kidney transplants.'
Here, American surgeons carry out hand transplant surgery.
Image: John Lair, courtesy of Jewish Hospital; Kleinert, Kutz and Associates Hand Care Center; University of Louisville
Your question:
What is the likely psychological impact for the woman who has received the transplant?
What is the likely psychological impact for the woman who has received the transplant?
Peter's answer:
'If the surgery is as successful as reports suggest, the woman's appearance will improve enormously - and her improvement in appearance and function will be the biggest psychological benefit.
'If the surgery is as successful as reports suggest, the woman's appearance will improve enormously - and her improvement in appearance and function will be the biggest psychological benefit.
These pictures show what a face transplant might look like. The top row shows these two people in real life; on the bottom is a simulation of how they could look if they 'swapped' faces.
Image: Peter Butler
'Our research shows that the donor's identity doesn't transfer to the recipient because the underlying facial structure is different. But the recipient has to be robust enough to cope with looking completely different.'
Your question:
Is it likely that we will see face transplants in the UK soon?
Is it likely that we will see face transplants in the UK soon?
Peter's answer:
'It's more than likely. There is an ethical question about who should decide whether surgery should proceed - the patient? The surgeon? Society? The Science Museum? In the end it's a contract between the surgeon and the patient.
'It's more than likely. There is an ethical question about who should decide whether surgery should proceed - the patient? The surgeon? Society? The Science Museum? In the end it's a contract between the surgeon and the patient.
'We've worked carefully with our hospital's ethics committee and I think we have worked through the concerns. The remaining hurdle is finding the right patient. We're working on patient selection criteria to help to make the surgery a success, medically and psychologically.
'The demand is definitely there - statistics show there are about 250,000 people in the UK with severe facial disfigurement.'
Your question:
Should donor cards include giving consent for the use of your face?
Should donor cards include giving consent for the use of your face?
Peter's answer:
'No - we're talking about a small number of patients, and for many people it's not yet an acceptable idea.'
'No - we're talking about a small number of patients, and for many people it's not yet an acceptable idea.'
Your question:
Is there any likelihood that face transplant surgery could be used by criminals, as in the film Face Off?
Is there any likelihood that face transplant surgery could be used by criminals, as in the film Face Off?
Peter's answer:
'No. Face transplants offer a massive improvement in appearance for patients with disfigurement, but they're not normality. Recipients have to take immunosuppressant drugs for the rest of their lives to stop the tissue being rejected.
'No. Face transplants offer a massive improvement in appearance for patients with disfigurement, but they're not normality. Recipients have to take immunosuppressant drugs for the rest of their lives to stop the tissue being rejected.
'Surgical implants or jaw reshaping would be alternative options, but perhaps a wig or dark glasses would be cheaper and easier.'
To find out more about Peter and his face transplant team visit: