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 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.
Surgeons get to work on the world's first ever face transplant operation.
Image: CHU de Lyon
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
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.
Will the woman who has received the transplant regain full feeling in her face?
'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.
Is it likely that the transplant will be rejected - and what would they do then?
'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.
Is the face transplant surgery similar to the hand transplants that have taken place?
'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
What is the likely psychological impact for the woman who has received the transplant?
'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
Is it likely that we will see face transplants in the UK soon?
'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.
Should donor cards include giving consent for the use of your face?
'No - we're talking about a small number of patients, and for many people it's not yet an acceptable idea.'
Is there any likelihood that face transplant surgery could be used by criminals, as in the film Face Off?
'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.