Spanish doctors who carried out a full face transplant on a man who injured himself in a shooting accident five years ago that left him unable to breathe or swallow, said the operation, the first of its kind in the world, has been a success.
The 30-doctor team at Vall d’Hebron University Hospital in Barcelona operated for over 20 hours to transplant a completely new face from the donor to the recipient, a young farmer who accidentally shot himself in the face in 2005.
The recipient, who now has new facial skin and muscles, jaw, cheekbones, nose, lips, teeth, and eyelids, underwent the transplant in March, but news of the transplant has only been announced in the last few days. The patient is said to be recovering well.
Although worldwide there have been 10 partial face transplants, this is the first complete one, and the most complex, according to the hospital.
Speaking for the hospital, Bianca Bolt told the BBC that this was the “first to transplant all of the face and some bones of the face”.
The procedure started with a four hour operation to remove the face from the dead donor. This removed veins, arteries, skin, muscles and bone. Part way through this procedure they anesthetized the recipient and removed skin grafts from his face.
The final stage was then to transplant the donor face and blood vessels onto the recipient, in one piece, using microvascular surgery to stitch the blood vessels precisely in place.
Dr Joan Pere Barret, who headed the transplant team, said they transplanted the face like a mask onto the patient, who now has a completely new face from his hairline to his neck. You can only see one scar, like a wrinkle across his neck, said Barret, adding that the patient is able to walk around his room and watch television.
No details of the donor have been released, except Barret said they were of similar weight, height, facial proportions and skin tone as the recipient.
Experts worldwide have praised the surgery, which was carried out on 20 March.
Dr Thomas Romo, chief of facial and reconstructive surgery at Lenox Hill Hospital in New York, told Associated Press that:
“It is a breakthrough. They are pushing the envelope and I am very happy for them.”
British experts agree this is probably the most complex face transplant yet, as it appears to include more bone and more of the lower face.
A spokesperson for the UK’s Facial Transplantation Research Team told the BBC it was “a tremendous achievement”, and shows how such operations can help the few most severely injured people for whom facial reconstruction either isn’t feasible or hasn’t worked.
The Spanish patient, who has not been named, shot himself in the face by accident with a shotgun in 2005, destroying his face from the eye sockets downwards, without damaging his eyes and eyesight.
Before the transplant he underwent nine operations, was unable to speak properly, was only able to breathe with a ventilator and take food through a tube.
Barret said he still can’t eat, speak or smile, reported the Associated Press, but he can see and swallow saliva. Doctors expect him to be able to eat and breathe on his own in the next few days.
Sources: AP, BBC.
Written by: Catharine Paddock, PhD