Face Transplant in France.

[Maraxus]

By CAROLE BIANCHI, Associated Press Writer 23 minutes ago

LYON, France - Doctors in France said they had performed the world's first partial face transplant, forging into a risky medical frontier with their operation on a woman disfigured by a dog bite.
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The 38-year-old woman, who wants to remain anonymous, had a nose, lips and chin grafted onto her face from a brain-dead donor whose family gave consent. The operation, performed Sunday, included a surgeon already famous for transplant breakthroughs, Dr. Jean-Michel Dubernard.

"The patient's general condition is excellent and the transplant looks normal," said a statement issued Wednesday from the hospital in the northern city of Amiens where the operation took place. Dubernard would not discuss the surgery, but confirmed that it involved the nose, lips and chin.

"We still don't know when the patient will get out," he said. A news conference is planned for Friday.

Scientists in China have performed scalp and ear transplants, but experts say the mouth and nose are the most difficult parts of the face to transplant. In 2000, Dubernard did the world's first double forearm transplant.

The surgery drew both praise and sobering warnings over its potential risks and ethical and psychological ramifications. If successful — something that may not be known for months or even years — the procedure offers hope to people horribly disfigured by burns, accidents or other tragedies.

The woman was "severely disfigured" by a dog bite in May that made it difficult for her to speak and chew, according to a joint statement from the hospital in Amiens and another in the southern city of Lyon where Dubernard works.

Such injuries are "extremely difficult, if not impossible" to repair using normal surgical techniques, the statement said.

"For pushing the bounds of science, they are to be applauded, as long as they have got full informed consent from the patient and the donor's family," added Dr. Iain Hutchison, chief executive of the London-based Facial Surgery Research Foundation.

Scientists around the world are working to perfect techniques involved in transplanting faces. Today's best treatments leave many people with facial disfigurement and scar tissue that doesn't look or move like natural skin.

A complete face transplant, which involves applying a sheet of skin in one operation, has never been done before. The procedure is complex, but uses standard surgical techniques.

Critics say the surgery is too risky for something that is not a matter of life or death, as regular organ transplants are.

The main worry for both a full face transplant and a partial effort is organ rejection, causing the skin to slough off.

"It is not clear whether an individual could be left worse off in the event that a face transplant failed," said Dr. Stephen Wigmore, chair of the ethics committee of the British Transplantation Society.

Complications also include infections that turn the new face black and require a second transplant or reconstruction with skin grafts, perhaps even one or two years later. Drugs to prevent rejection are needed for life and raise the risk of kidney damage and cancer.

Such concerns have delayed British plans to attempt the operation. In France, ethics authorities rejected an application to try a full face transplant last year, but left the door open for a partial procedure involving the mouth and nose.

In the United States, the Cleveland Clinic is among those planning to attempt a face transplant.

The French surgery "doesn't change our plans," said Cleveland surgeon Dr. Maria Siemionow. "We are really looking for the right candidate," which she described as "severely disfigured patients which have already had the conventional treatment" and for whom a transplant is the last chance.

Dubernard, who is also a lawmaker in France's lower house of parliament, collaborated in the operation with the Amiens hospital's Dr. Bernard Devauchelle. Weekly news magazine Le Point reported that the recipient lives in Valenciennes, in northeast France, and that the donor's facial organs were removed in a hospital in Lille, about 60 miles from where the transplant was performed.

In 1976, Dubernard performed Europe's first pancreas transplant. He also led teams that performed a hand transplant in September 1998 and the world's first double forearm transplant in January 2000.

The hand transplant recipient, New Zealander Clint Hallam, later had it amputated. Doctors said he failed to take the required drugs and his body rejected the limb.

The double-forearm recipient, Denis Chatelier from France, said in 2003 that he had regained "normal usage" of his hands and was even able to shave himself. His forearms were severed in a model rocket accident.

Doctors from Jinling Hospital in Nanjing, China, reported that in September 2003, they transplanted two ears, part of the scalp and other facial skin from a brain-dead young man to a 72-year-old woman with advanced skin cancer.

Four months later, there were no signs of rejection or tumor recurrence, but it is not known how the patient fared after that.

Doctors around the world have performed partial face transplants using the patients' own skin, but these don't require anti-rejection drugs.

[Broomstick]

I hope for the patient's sake that all goes well.

[wolveraptor]

Holy shit, imagine if you were the family that consented to donate your brain-dead relative's skin. If you ever saw the recipient again, you'd see your dead relative's face! Man, that would be creepy as hell.

Though I imagine that with different facial structures, it wouldn't look quite the same.

[Bounty]

Holy shit, imagine if you were the family that consented to donate your brain-dead relative's skin. If you ever saw the recipient again, you'd see your dead relative's face!

With the transplant, new muscle structure, new bone structure and scarring, I doubt it'd be recognisable.

[Kuja]

Just a simple matter of time, bitches.

[Admiral Valdemar]

And this time 8 years ago, we were laughing at that idea in a movie. Now it's real. Funny how that works.

[Trytostaydead]

Hi doses of cyclosporins and I'm sure we can transplant penises

[Sea Skimmer]

Just a simple matter of time, bitches.

Except for the whole ‘different blood types’ issue they mentioned and yet totally ignored in the movie

[Broomstick]

Holy shit, imagine if you were the family that consented to donate your brain-dead relative's skin. If you ever saw the recipient again, you'd see your dead relative's face! Man, that would be creepy as hell.

Though I imagine that with different facial structures, it wouldn't look quite the same.

Assuming no bone is involved, the face would definitely look different. There would, of course, be some resemblance in skin color, texture, moles, wrinkles, previous scars, etc. but the differences in the underlying bone and muscle would significantly alter the appearance of the donated tissue.

As part of the research leading up to this sort of surgery, doctors performed practice procedures on cadavars. As part of that, they took pictures of the face before being harvested and after transplant. They then took the faces to groups of present and student doctors that work in the reconstructive/plastic surgery field. They showed the "before" picture to the doctors, then had them try to pick the "after" picture out of a group of 12-15 photos. The doctors - who presumably know faces really, really well - were unable to consistently pick out the transplanted face.

That was with cadavars - with a living person, who's facial expressions would be different from the donor's, the differences would be even greater. The hair around the face - color, texture, styling - would also be considerably different. In the case of women, who might pluck eyebrows, use make up, etc., in a different manner than the donor the differences become greater yet.

So, walking down the street the recipient might remind you of the relative who's face you donated, but no more than a lot of other people would, and probably a lot less than the donor's siblings and counsins.

It is analogous to the case of the transplanted larynx, which occured some years ago. The recipient's voice box had been completely destroyed and removed. After the transplant (which was successful, by the way) his resulting voice was neither his old voice nor was it the voice of the donor. It had the same pitch as the donor's voice (same vocal cords, after all) but because the recipient's throat, mouth, and other oral structures were different, and because the recipient had different accent, cadences, and other vocal characteristics it was sufficient to alter the resulting voice to the point that no one was going to mistake the recipient's speech for the donor's.

I am somewhat surprised that pictures of the face transplant have ben released to the public - not only did I see some on websites, but this morning CNN wwas broadcasting a close-up. So much for anonymity.

By now, the worst danger of blood clots and interrupted circulation have passed, which is a good thing for the recipient. I hope things continue to go well for her. From here on out it's infection and rejection that needs to be kept at bay.

[Max]

Not to be morbid, but where can one find the before and after pictures.

[Trogdor]

Not to be morbid, but where can one find the before and after pictures.

The patient wishes to remain anonymous, so there won't be any such pictures floating around.

[Broomstick]

Not to be morbid, but where can one find the before and after pictures.

If you are referring to the before and after pictures of cadavar procedures I referenced - they are not available, being restricted to just the researcher involved and they have taken steps to ensure they are not released to the public.

If you are referring to the results of the recent French partial face transplane - available on CNN, BBC, and other fine news sites.