Isabelle Dinoire: Life after the world's first face transplant - BBC News BBC News Isabelle Dinoire: Life after the world's first face transplant By Mike Lanchin BBC World Service, Amiens 27 November 2012 Close share panel Image caption Isabelle Dinoire before her injuries, just after the operation, and in 2009 Seven years ago Isabelle Dinoire became the first-ever person to have a face transplant. In a rare interview, she describes how she copes with the stares, and her yearning to meet the family of the woman whose face became her own. "The most difficult thing is to find myself again, as the person I was, with the face I had before the accident. But I know that's not possible," says the 45-year-old mother of two from northern France. "When I look in the mirror, I see a mixture of the two [of us]. The donor is always with me." After a moment, she adds: "She saved my life." Dinoire regularly turns down media requests and rarely agrees to be photographed. She comes across as relaxed and self-assured, but her traumatic ordeal has left its mark, physically and mentally.

She still has a visible scar running from above her nose to down under her chin where specialist doctors at Amiens University Hospital in northern France, spent 15 hours sewing the donor's face on to hers. One of her eyes is slightly drooping. If people stare at me insistently, I don't care any more, I just stare back Speaking with a slight impediment - and with almost alarming simplicity - she recounts how, in a fit of depression in May 2005, she took an overdose of sleeping pills in an attempt to end her life. She awoke to find herself at home, lying beside a pool of blood, with her pet Labrador at her side. The dog had apparently found her unconscious, and desperate to rouse her, had gnawed away at her face. "I couldn't even begin to imagine it was my face or my blood - or that the dog had chewed my face," she says. The injuries to her mouth, nose and chin were so extreme that doctors immediately ruled out a routine face reconstruction. Instead they proposed a ground-breaking face transplant.

Face transplant timeline November 2005 - Isabelle Dinoire becomes the first person in the world to have a face transplant (nose, lips and chin) in France April 2010 - The world's first full face transplant is done by a team of doctors in Spain March 2012 - US doctors conduct the most extensive face transplant to date (above - image courtesy University of Maryland Medical Center) There have also been face transplants in Turkey and China "From the first time I saw myself in the mirror after the operation I knew it was a victory. It didn't look that good because of all the bandages, but I had a nose, I had a mouth - it was fantastic," she says. "I could see in the eyes of the nurses that it was a success." Unable to speak properly due to a tracheotomy done for the operation, all she could murmur was a simple, "Thank you." Dinoire's delight at her new face, however, quickly turned sour. She was completely unprepared for the attention her case brought her.

Pursued by the media, harassed by passers-by and curious onlookers, Dinoire spent months after the operation hidden away at home, not daring to venture out. "It was excruciating. I live in a small town and so everyone knew my story. It wasn't easy at the beginning. Children would laugh at me and everyone would say, 'Look it's her, it's her.'" She felt like "a circus animal". Nowadays, people still recognise her around town, but the attention is "not as brutal" as before, she says. "With time I have got used to my own face. This is what I look like, what I am like, who I am. If people stare at me insistently, I don't care any more, I just stare back!" she says, with a hint of a smile. I look at myself in the mirror and think of her - and I tell myself I'm not allowed to give up But has her personality changed as well as her outward appearance?

"No" she replies quickly, "I am the same, just with a different face." According to Prof Sylvie Testelin, one of the team that operated on Dinoire in Amiens, not every patient with severe facial injuries can be offered the chance of a transplant. In 2005 no-one was really sure of the long-term effects on patients of taking a cocktail of drugs for the rest of their lives to prevent their body rejecting the new tissue. But in the case of Dinoire - and the two other people in France who have had successful transplants since then - the benefits have far outweighed the risks. Find out more Browse the archive "Nobody can imagine what it's like to live without a face. She [Isabelle] can. But we must be sure it is right for the patient," says Testelin. Worldwide there have been a dozen or so successful operations - in the US, Spain, Turkey and China. "You cannot imagine the number of people who have wanted transplants, but it's not a game or a race to do more and more," she says. One day Dinoire will have to face up to the possibility of a major rejection by her body, says Testelin.

As her doctor, she too has to be prepared for this - though she hopes that day never comes. How it's done Face from dead donor is removed - veins, arteries, skin, muscles, and even some bones are taken The patient is anaesthetised partway through surgery on the donor The donor face and accompanying blood vessels are stitched to the patient Dinoire is more sanguine about her future. "I tell myself it will be all right. If I take my drugs everything should go well," she says. She spends her days visiting a few close friends and walking her new pet dog - she was devastated that the Labrador she had in 2005 was put down. Still prone to bouts of depression, she says she constantly thinks about the dead woman whose face she was given. Right after the operation she would surf the internet in search of details of the anonymous donor - whose identity French law will never allow her to know. "When I feel down, or depressed, I look at myself in the mirror again and think of her. And I tell myself, I'm not allowed to give up.

She gives me hope." One day Dinoire would even like to be able to meet the woman's family, to thank them for what she describes as their "magical donation". Mike Lanchin's interview with Isabelle Dinoire was broadcast on the BBC World Service's Witness programme . You can download a podcast of the programme or browse the archive . You can follow the Magazine on Twitter and on Facebook 7 Amazing Face Transplants (face transplants, full face transplant) - ODDEE 7 Amazing Face Transplants 1 Richard Lee Norris: The man with the most extensive face transplant ever performed These are the incredible before-and-after pictures of 37-year-old Richard Lee Norris who was given the most extensive face transplant ever performed. Mr. Norris, who was injured in a 1997 gun accident, was pictured seven months after being given a new face, teeth, tongue and jaw in a 36-hour surgery at the University of Maryland Medical Center. For 15 years, Mr. Norris lived as a recluse in Hillsville, Virginia, hiding behind a mask and only coming out at night time. He can now feel his face and is able to brush his teeth and shave.

He's also regained his sense of smell, which he had lost after the accident. When he shot himself in the face in 1997, Mr. Norris lost his nose, lips and most movement in his mouth. He has had multiple life-saving, reconstructive surgeries which also replaced underlying nerve and muscle tissue from scalp to neck. Motor function is now 80 percent on the right side of the face and 40 percent on the left. ( Source ) 2 Isabelle Dinoire: The first person to undergo a partial face transplant Isabelle Dinoire is a French woman who was mauled by a Labrador after she had overdosed on sleeping pills in May 2005. While she was passed out, Tania – the dog Isabelle Dinoire loved so much - came to her and started scratching and chewing on her face. There are speculations that the dog got frantic after seeing her master unresponsive and was possibly trying to wake her. After she was mauled, Isabelle Dinoire was left without lips and with part of her nose, chin and cheeks missing.

She was scheduled to undergo face transplant operation which took place on November 27, 2005 at the Centre Hospitalier Universitaire Nord in Amiens, France. Isabelle Dinoire is the first person ever to have undergone a partial face transplant. ( Source ) 3 Dallas Wiens: The first American to receive a full face transplant Dallas Wiens (born May 6, 1985) is the first United States recipient of a full face transplant, performed at the Brigham and Women's Hospital during the week of March 14, 2011. It was the first such operation in the United States and the third in the world. Wiens of Fort Worth, Texas was severely disfigured in 2008 when he came in contact with an active high-voltage power line. He was standing inside the cherry picker when his forehead made contact with a high-voltage wire. Transported by helicopter to Parkland Memorial Hospital, surgeons spent 36 hours over two days working to save Wiens' life. Wiens was left permanently blind and without lips, a nose or eyebrows.

Doctors told the family that Wiens likely would be paralyzed from the neck down and would never speak or produce enough saliva to eat solid food. They put him in a medically-induced coma for 3 months. After awakening, he made unprecedented progress and left the hospital in the spring of 2009. In May 2010 he started walking. In March 2011, a transplant team of more than 30 doctors, including eight surgeons and doctors and nurses from multiple disciplines led by MUDr. Bohdan Pomahač, performed a full face transplant at Brigham and Women's Hospital in Boston. It took 15 hours. Wiens' sight couldn't be recovered but he has been able to talk on the phone and smell. ( Source ) 4 Connie Culp: The woman who had a face transplant after being shot in the face by her ex husband Connie Culp is a 46-year-old Ohio woman who has had the first face transplant in the US after being shot by her husband. Her new look was a far cry from the puckered, noseless sight that made children shrink away in horror.

Culp's expressions are still a bit wooden, but she can talk, smile, smell and taste her food again. Her speech is, at times, a little tough to understand. Her face is bloated and squarish, and her skin droops in big folds that doctors plan to pare away as her circulation improves and her nerves grow, animating her new muscles. Culp's husband, Thomas, shot her in 2004 then turned the gun on himself. He went to prison for seven years. His wife was left clinging to life. The blast shattered her nose, cheeks, the roof of her mouth and an eye. Hundreds of fragments of shotgun pellet and bone splinters were embedded in her face. She needed a tube into her windpipe to breathe. Only her upper eyelids, forehead, lower lip and chin were left. She endured 30 operations. Doctors took parts of her ribs to make cheekbones and fashioned an upper jaw from one of her leg bones. She had countless skin grafts from her thighs. Still, she was left unable to eat solid food, breathe on her own, or smell. Then, in a 22-hour operation, Dr.

Maria Siemionow led a team of doctors who replaced 80 percent of Culp's face with bone, muscles, nerves, skin and blood vessels from another woman who had just died. It was the fourth face transplant in the world. No information has been released about the donor or how she died, but her family members were moved when they saw before-and-after pictures of Culp. ( Source ) 5 Pascal Coler: The man who had his face disfigured by a genetic disease receives a new face These pictures reveal the amazing transformation of Pascal Coler, a modern-day Elephant Man. Mr. Coler's face had been horribly disfigured by Von Recklinghausen's disease, a rare genetic disorder. But in 2008, a team of French surgeons, headed by Professor Laurent Lantieri, gave him a new lease on life. The controversial operation, which involved replacing Mr. Coler's face with that of a dead donor, took 16 hours, the News of the World reported. In the operation, tissues, nerves, arteries and veins were all attached to the patient's face. Mr. Coler described the day of his surgery as the happiest of his life.

( Source ) 6 The man who had his face partially reconstructed after having his nose ripped off by a bear A 30-year-old man was attacked by a bear in October 2004. In the bear attack a large section of the man's face was ripped off and doctors decided to attempt a transplant after skin grafts from his arm failed. The face donor was a 25-year-old man who had died in a traffic accident. After consent was obtained from the donor's family, the transplant operation was performed in April 2006. Professor Shuzhong Guo from Xijing Hospital and Fourth Military Medical University in Xi'an, Shaanxi Province, China led the team of plastic surgeons. During an 18-hour operation, they re-connected arteries, veins and nerves and repaired the nose, upper lip, and sinuses. Four different drugs were administered to reduce the chances of tissue rejection. ( Source ) 7 Ugur Acar: The teenager who had a new face for the first time since a fire accident when he was just a baby This is the incredible moment when a teenager who underwent Turkey's first facial transplant sees his new face for the first time.

Ugur Acar, 19, suffered serious burns to his face during a house fire when he was just 40 days old. He had a cosmetic procedure to repair his face in 2012 at Akdeniz University's School of Medicine in southern Turkey. His face was freshly shaven before he looked into the mirror, as he had been forced to grow a beard over the three weeks since the operation to avoid irritating his skin. Doctors successfully transplanted tissue from the face of a 45-year-old donor to Mr. Acar. They are planning to discharge Mr. Acar from the hospital in 45 days. ( Source ) From the Web Face transplant woman appears / French citizen thanks doctors, donor for her new nose, chin, mouth - SFGate Face transplant woman appears / French citizen thanks doctors, donor for her new nose, chin, mouth Ariane Bernard, Craig S.

Smith, New York Times Published 4:00 am, Tuesday, February 7, 2006 Photo: MICHEL SPINGLER Close Image 1 of 3 Isabelle Dinoire, the woman who received the world's first partial face transplant with a new nose, chin and mouth in a transplant operation on Nov. 27, 2005, addresses reporters with Dr Sophie Testin, left, during her first press conference since the transplant at Amiens hospital, northern France Monday Feb. 6, 2006. The 38-year-old woman was mauled by a dog in May, leaving her with severe facial injuries that her doctors said made it difficult for her to speak and eat. (AP Photo/Michel Spingler) less Isabelle Dinoire, the woman who received the world's first partial face transplant with a new nose, chin and mouth in a transplant operation on Nov. 27, 2005, addresses reporters with Dr Sophie Testin, left, ...

more Photo: MICHEL SPINGLER Image 2 of 3 Isabelle Dinoire, the woman who received the world's first partial face transplant with a new nose, chin and mouth, in an operation on Nov. 27, 2005, addresses reporters during her first press conference since the transplant at the Amiens hospital, northern France Monday Feb. 6, 2006. The 38-year-old woman was mauled by a dog in May, leaving her with severe facial injuries that her doctors said made it difficult for her to speak and eat. (AP Photo/Michel Spingler) less Isabelle Dinoire, the woman who received the world's first partial face transplant with a new nose, chin and mouth, in an operation on Nov. 27, 2005, addresses reporters during her first press conference since ... more Photo: MICHEL SPINGLER Before Surgery. New York Times Graphic Before Surgery.

New York Times Graphic Face transplant woman appears / French citizen thanks doctors, donor for her new nose, chin, mouth 1 / 3 Back to Gallery 2006-02-07 04:00:00 PDT Amiens, France -- Isabelle Dinoire , the French woman who received the world's first partial face transplant, appeared before a roomful of reporters here Monday, speaking in a slurred voice about her ordeal and thanking the doctors and the donor who have given her a new nose, mouth and chin. "Since the day of the operation, I have a face like everybody else," said Dinoire, 38, seated on a dais with her doctors in an amphitheater of the hospital where the transplant was performed in November. Though her lower lip hangs pendulously, exposing her lower teeth, and her perpetually open mouth barely moves as she speaks, Dinoire said she has begun to feel her transplanted skin. Dinoire's press conference was meant to ease public curiosity about the transplant and to show the world that the innovative post-transplant treatment was working.

Though Dinoire's lower face barely moves and she speaks with difficulty -- her "s" sounds coming out like "sh" -- the thin scar surrounding the transplant was barely visible at a distance. At one point during the press conference, she drank water from a plastic cup. Dr. Jean-Michel Dubernard , who is in charge of her immunosuppressive treatment, said there is still a danger that Dinoire's body will reject the transplant and that her medication had already been adjusted to suppress signs of rejection that appeared 18 days after the operation. But he said that he has asked the French health authorities for permission to carry out five similar operations in the future. "We want to launch these new techniques to give hope to other people all over the world," Dubernard said. Dinoire described how she awoke to discover her horrible disfigurement after her black Labrador chewed off the lower part of her face while she was unconscious from taking sleeping pills in May in what many people contend was a suicide attempt. "On May 27, after a very disturbing week and with lots of personal worries, I took drugs to forget," Dinoire said, adding that she passed out and fell against a piece of furniture.

"When I woke up, I tried to light a cigarette and didn't understand why it wouldn't stay between my lips," she said, her face slack and emotionless. "That's when I saw the pool of blood and the dog." Dinoire said she went to look at herself in a mirror and "couldn't believe what I was seeing, it was too horrible." Her lips were gone, along with her chin and much of her nose, leaving her teeth and part of her lower jawbone exposed. After calling her mother, who lived nearby, an ambulance rushed her to the local hospital. The doctors there transferred her to the care of Dr. Bernard Devauchelle , a renowned maxio-facial surgeon at the university hospital in Amiens. Dinoire's torn facial muscles contracted, leaving her unable to open her mouth more than a few millimeters and forcing her to eat all of her food pureed. Even after rigorous physical therapy, she could only open her mouth about three-quarters of an inch by the time the transplant was performed. "Now, I just open my mouth and eat," she told the reporters at the press conference, during which she occasionally smiled with her eyes, her peripheral facial muscles tugging her mouth into the hint of a smile.

Dinoire's doctors said it would be months before they would know how much motor control she would develop in the transplanted part of her face. Dinoire said that "being able to show emotions through my face" was the best thing about her transplant and said she hopes to eventually be able to smile and grimace. She said the stares she received, even when wearing a surgical mask, were the worst thing about her disfigurement and that she didn't leave her room in the hospital for a month and a half after her disfigurement. Now she said she is able to go into public without drawing much attention, though she said she continued to live in the hospital because of the harassment she has received from the news media. She said she had not spent very much time with her two daughters, aged 13 and 17, but that she was satisfied with their reaction to the transplant. She said she hopes to return to live with her daughters and eventually begin working again. She defended her decision to resume smoking within weeks of the transplant, which drew sharp criticism from the media.

She said it has been a long ordeal, but that "in the end, I never really suffered." Latest from the SFGATE homepage: Click below for the top news from around the Bay Area and beyond. Sign up for our newsletters to be the first to learn about breaking news and more. Go to 'Sign In' and 'Manage Profile' at the top of the page. World's First Female Face Transplant - Extraordinary People - YouTube World's First Female Face Transplant - Extraordinary People Want to watch this again later? Sign in to add this video to a playlist. Need to report the video? Sign in to report inappropriate content. The interactive transcript could not be loaded. Loading... Rating is available when the video has been rented. This feature is not available right now. Please try again later. Published on Sep 30, 2013 Doctors have been transplanting livers, kidneys, and hearts for over forty years - but faces have always been different. They are seen as a sacred and untouchable part of our identity. Unlike other organs, face transplants are not life saving operations. As a result, ethical committees have always blocked them from going ahead.

In November 2005, 37 year old, mother of two, Isabelle Dinoire became the first person in the world to receive a new face. The decision made by French surgeons to perform the operation went against the findings of almost every other ethical committee in the world and has since sparked a fierce debate over the ethics of the operation. World's First Female Face Transplant- Recovery of face-transplant patient plagued by obstacles - Houston Chronicle Recovery of face-transplant patient plagued by obstacles But the French woman says she is 'very satisfied,' and some critics of surgery are quieted RICK WEISS, Washington Post Published 6:30 am, Thursday, December 13, 2007 Photo: NEW ENGLAND JOURNALOF MEDICINE Image 1of/3 This June 2001 photo shows Isabelle Dinoire years before she was disfigured in 2005. This June 2001 photo shows Isabelle Dinoire years before she was disfigured in 2005.

Photo: NEW ENGLAND JOURNALOF MEDICINE Image 2 of 3 In February 2006, Dinoire made her first public appearance after her transplant. In February 2006, Dinoire made her first public appearance after her transplant. Photo: MICHEL SPINGLER, ASSOCIATED PRESS FILE Image 3 of 3 Dinoire, shown in June 2007. Her recovery has quieted some skeptics. Dinoire, shown in June 2007. Her recovery has quieted some skeptics. Photo: NEW ENGLAND JOURNALOF MEDICINE Recovery of face-transplant patient plagued by obstacles 1 / 3 Back to Gallery WASHINGTON — A French woman who two years ago became the first person to receive a face transplant has recovered with remarkably good aesthetic results and has gradually regained normal skin sensation and control of her facial muscles, doctors reported Wednesday in the first detailed account of her progress.

Isabelle Dinoire , who at age 38 lost her lips, cheeks, chin and most of her nose when she was mauled by her dog, now blends into crowds and attends parties comfortably with the face she got from a 46-year-old brain-dead donor, which surgeons attached like a mask in a landmark 15-hour surgery. Her recovery, however, has at times been harrowing, her surgeon, Jean-Michel Dubernard , acknowledged. Twice her immune system has mounted violent reactions against the new tissue, one of several anticipated risks that had led some experts to question the wisdom of the surgery. The immune-suppressing drugs she must take for the rest of her life have also wreaked havoc, causing infections and, at one point, kidney failure. 'Proved me wrong' But Dinoire is "very satisfied" with the outcome, the medical team reports in today's issue of the New England Journal of Medicine . And although some experts remain uncomfortable with the experiment, including its lack of psychological follow-up, some who were initially critical of the attempt said they are impressed.

"They proved me wrong," said Peter Butler of the Royal Free Hospital in London, who has been organizing a slower paced effort to transplant faces in England. "Her neuromuscular recovery looks good. She's done extremely well." The circumstances of Dinoire's injury remain mysterious. She was unconscious when her dog chewed off much of her face on May 28, 2005. Some have suggested she had tried to take her own life, though Dubernard, of Lyon University , has said she merely took a sleeping pill and may have stumbled and startled the animal. Whatever the cause, the injury was devastating. Lipless and lacking key muscles, Dinoire could not speak and was fed through a tube. Questions of ethics At the time, teams in several countries were developing controversial plans to transplant faces, raising concerns among ethicists and others that a race-to-be-first was underway. Critics said the risks — including the possibility of total rejection, leaving the person worse off than before — were not justified to fix a non-life-threatening injury. Others wondered about the psychological impact of wearing another's visage, given the personal and cultural import of the face as a core element of identity.

But with Dinoire's consent, much of the donor's face — a triangular swatch of skin, including lips, muscles, nerves and blood vessels — was microsurgically attached on Nov. 27, 2005. The new report covers the first 18 months of recovery. Two other face transplants have since been performed, in China and in France by a different team. Neither has yet described their results, but the new report suggests that the field has a future, said Warren Breidenbach , a member of Kleinert Kutz and Associates , a surgical team developing methods for face transplants. "This is a better reconstruction than you could obtain from conventional methods," said Breidenbach, who in 1999 helped perform the first successful U.S. hand transplant. Latest from the Chron.com Homepage Click below for the top news from around the Houston area and beyond. Sign up for our newsletters to be the first to learn about breaking news and more. Go to 'Sign In' and 'Manage Profile' at the top of the page.

Face Transplant, First | Isabelle Dinoire | Stranger than Fiction Stranger than Fiction First Face Transplant | Isabelle Dinoire The First Face Transplant A young woman with a horrific face injury, made medical history in November 2005. French doctors took a controversial decision to perform an operation that had been banned in almost every other country in the world. For some, it has redefined the boundaries of transplant surgery. A face transplant even a partial face transplant had never been done before. Isabelle Dinoire, the recipient of the world’s first face transplant, lives in Valenciennes, Northern France. Born in 1967, she is divorced with two teenage daughters. Mauled by her pet Labrador in May 2005, she lost her nose, lips and chin. Astonishingly, she did not seek medical attention immediately. Instead she chose to hide away, too ashamed to go out with her disfigured face. Isabelle Dinoire Professor Sylvie Testelin remembers: “This woman turned up on a stretcher, it was three weeks after the accident. She had a loose bandage over her face and a stomach tube feeding her. She couldn’t take anything in through her mouth”.

Isabelle is NOT Grimacing, she has no lips The extent of the Facial Damage Several weeks after being admitted to hospital, Isabelle came to the attention of specialist maxilla-facial surgeon Professor Bernard Devauchelle. Using conventional surgery, doctors are limited in what they can do to reconstruct Isabelle’s face. Dr. Devauchelle believed there was an alternative: “This type of tissue loss requires this type of treatment, anything else is just a make-shift solution. The best way, the only way, to fix it is with a face transplant”. At the Royal Free Hospital, in London, surgeon Peter Butler has dedicated his career to researching face transplantation: “Facial transplantation is not a new idea. We have known for some time that this is technically possible because we have been looking into it for 14 years experimentally and nearly 6 years clinically. I’m convinced this is a good thing to do and is a therapeutic possibility”. Doctors have been transplanting livers, kidneys and hearts for over forty years, but faces have always been different. They are seen as a sacred, untouchable part of our identity. Unlike other organs, face transplants are not life-saving operations.

As a result, ethical committees have always blocked them from going ahead. Bernard Devauchelle Surgeon Bernard Devauchelle However, in France, surgeons Bernard Devauchelle and Sylvie Testelin believed that, in Isabelle, they had a unique case, worthy of ethical approval. Convinced that they will get approval, Sylvie Testelin and Bernard Devauchelle assembled a team of specialists including world famous transplant surgeon Jean-Michel Dubernard. Dubernard and his team were already medical pioneers having performed the first successful hand transplant. Jean-Michel Dubernard Surgeon Jean-Michel Dubernard Jean-Michel Dubernard said, on joining the team: “Once I had seen Isabelle’s disfigured face, no more needed to be said. I was convinced something had to be done for this patient”. While Isabelle waited for permission for her transplant, doctors were worried that her condition was deteriorating. Her muscles had slowly tightened, making it difficult for her to open her mouth more than a few millimetres. During this time, doctors conducted extensive, scientific, tests to see how her brain might function after the transplant.

MRI scans showed that, even though her lips were missing, the part of her brain that controls the lips was still active, which should allow her to control the muscles of a new face. Peter Butler is frustrated by the limitations of conventional surgery in reconstructing the human face. “The skin of the face is very specialised. If you take a line from the hair-line to the chin, you will go through five or six different thicknesses of epidermis and dermis, with different numbers of hair follicles, sweat glands, and pigment changes. It is very difficult to reproduce using thigh skin or back skin”. Simon Weston Simon Weston – the Falklands Hero Simon Weston was just 20 years old when his troop-ship was struck by an Argentinean missile during the Falklands War. He suffered 49% burns and has undergone extensive reconstructive surgery. He explains Peter Butler’s frustration “My nose doesn’t look normal, my eyes can never look normal. My eyelids came from my shoulder, my nose came from my backside. It’s impossible to make it look normal”. After four months of waiting, the surgical team in Amiens have, finally, been given the permission they have been waiting for.

The ethical committee agreed that all the medical questions had been answered and Isabelle’s operation could proceed. Now, Isabelle Dinoire will begin the long and difficult wait for a suitable donor. The donor will need to be of a similar age and have the same skin colour and blood-group. Doctors plan to remove the nose, lips and chin from the donor face. The operation would be a first, but the surgical techniques have been established for decades. Surgeons have always hit one problem. Whenever they tried to transplant skin from one person to another, it would always be rejected. However, it was proved possible, in 1998, when they gave Clint Hallam a new hand. This was made possible by new anti-rejection drugs which suppress the body’s immune system to prevent donated organs being rejected. Hybrid of Donor and Recipient Face Donor Face will mould over the donor bone structure Besides the medical risks, their are serious concerns about the long-term psychological consequences of transferring one person’s face onto another. Peter Butler tells us: “The popular misconception of the public is ‘If I donate the face to my loved one, I will see them walking down the street’.

If you take the skin envelope off a face, which is pliable, and put it on the facial bones of the recipient, it will remould over the facial bones to give you most of the features from the bones, but with the skin tone and texture of the transplanted skin. The resultant face is a hybrid of both faces, but will look more like the recipient than the donor”. Six months after Isabelle Dinoire’s arrival at the hospital in Amiens, the call finally comes. A donor had been found in Lyon. The team swings into action. Dr Devauchelle collects the donor face while Dr Dubernard prepares Isabelle for the surgery. Using threads finer than a human hair, the major facial arteries are connected. The crucial test will be whether blood will flow through Isabelle’s veins to the newly transplanted face, bringing the flesh back to life. Immediately after the Face Transplant Bringing the transplanted face to life The moment of truth is when they unclamp the arteries and the blood starts to flow. Within minutes, the lips regain their colour, volume and density. With all the veins and arteries in place, the skin is finally stitched back together. After fifteen hours, the operation is complete.

From now, Isabelle Dinoire will be closely monitored to see if her body accepts the face transplant. She is transferred to Lyon where she will undergo months of tests. Doctors have detected some immunological signs of rejection, but increasing the dose of her medication has brought it under control. After several weeks, Isabelle Dinoire is showing signs of sensation returning to her face. Isabelle Post Face Transplant Isabelle Dinoire has a new face and a new life Even though the surgery was a success, she will be in and out of hospital for the rest of her life. But, she has her life back! She has the confidence to go out and meet people. She has decorated her house, she can eat and drink normally. She has even, despite strong protestations from her doctors, started smoking again. Following the success of Isabelle’s partial face transplant, Peter Butler has now redoubled his efforts to have the ethical committee in Britain give approval for the first full face transplant.

External Links Face-transplant breakthroughs - Incredible images from a decade saving face — RT America Face-transplant breakthroughs - Incredible images from a decade saving face Published time: 17 Nov, 2015 22:30 Get short URL Doctors explain the procedure on Patrick Hardison at a news conference in New York © Mike Segar A Tennessee firefighter whose face was destroyed in a 2001 house fire has received the world's most extensive face transplant. 41-year-old Patrick Hardison received the face of 26-year-old David Rodebaugh in a grueling 26-hour surgery. When Hardison was 26, he was a volunteer fireman in Senatobia, 40 miles south of Memphis, when he went out on a call for a house fire. There was a woman trapped inside the burning home. Hardison raced inside, hoping to save her. Moments later, the roof collapsed on him, knocking his helmet off and melting his mask. Hardison lost his eyelids, ears, lips and most of his nose in the fire. His hair burned off as well. Dr. Eduardo D.

Rodriguez shows a picture of transplant patient Patrick Hardison © Mike Segar / Reuters "From that day on ‒ September 5, 2001 ‒ there was no normal tissue left throughout his face," Eduardo D. Rodriguez, chair of plastic surgery at NYU Langone Medical Center, told reporters. Hardison went through a grueling 70 surgeries and multiple skin grafts, but still had "no semblance of normal anatomy," Rodriguez said. The former firefighter felt tremendous pain when trying to do everyday activities like talking or eating. Rodebaugh, a BMX cyclist from Ohio, died in July 2015. He was an organ donor. On August 14, Rodriguez and his team began the facial transplant. The operation, which the hospital estimates cost between $850,000 and $1 million, was funded by a grant from NYU Langone. The first face transplant surgery was performed ten years ago this month. We took a look at the extraordinary images of this complex, cutting-edge practice.

Partial transplants Isabelle Dinoire speaks for the first time after receiving a partial-face transplant © Pascal Rossignol / Reuters The first attempt at the procedure was in France ‒ a partial transplant on 38-year-old Isabelle Dinoire. She had been mauled by her dog, who was trying to wake her after an overdose of sleeping medication. Dinoire lost her nose, lips, chin and parts of her cheeks. Doctors spent 15 hours transferring skin, muscles, bones and blood vessels from a brain-dead suicide victim to Dinoire. The operation was a success but doctors advised her that her body could still decide to reject the face at any time. Dinoire and all subsequent face transplant patients are required to take anti-rejection medication for the rest of their lives. A doctor inspects Li Guoxing after the surgery © STR / Reuters In 2006 Li Guoxing underwent a similar partial transplant in China. He died two years later amid reports that he had stopped taking his anti-rejection medicine in favor of herbal remedies.

Connie Culp before and after her face-transplant © Cleveland Clinic / Reuters Connie Culp was the first person to receive a face -transplant in the US, in 2008. She required the surgery after her husband shot her in the face before killing himself. Her nose, cheeks, mouth and an eye were destroyed. She was also unable to breathe without assistance. Culp underwent a successful 22-hour surgery and now works as an advocate for organ donation. Charla Nash was not so fortunate, losing her hands and face when her neighbor's 200-pound chimpanzee attacked her in Connecticut. Charla initially went through a successful transplant of both face and hands, but the hands had to be removed shortly afterwards, as they failed to work with her body. Full transplants The 31-year-old identified as Oscar speaks at a press conference following his surgery © Marti Fradera / Reuters In 2010, doctors in Barcelona performed the first full face transplant on a farmer known only as Oscar, who had accidentally shot himself in the face. An entire face – including jaw, nose, cheekbones, muscle, teeth and eyelids – was placed onto Oscar's skull like a mask.

One week after the operation, the 31-year-old had to be shaved because he was growing a beard. Doctors noted this as a sign the operation was successful. Dallas Wiens after the surgery © Brian Snyder / Reuters The US was soon to follow, with a full transplant in March 2011 for Dallas Wiens, a painter whose face was burned off by a high-voltage wire. Although Wiens' sight could not be restored, doctors at Brigham and Women's Hospital in Boston, Massachusetts did manage to restore his sense of smell. The surgery was paid for by the US military as part of an initiative to learn how to help soldiers with severe facial wounds. Richard Norris before his face transplant surgery © University of Maryland Medical Center / Reuters Another full transplant in the US went to Richard Norris, in 2012. Norris lost his nose, lips and mouth movement in a 1997 gun accident. Norris lived as a recluse for 15 years after the accident and said the operation had given him his life back. His surgery was also funded by a grant from the US military, which estimates that over 200 soldiers may be eligible for face transplants.

Richard Norris after his face transplant surgery © University of Maryland Medical Center / Reuters Face transplants are still a new and complex medical procedure, with a 50/50 chance of success at best. The surgery also carries a massive risk, noted Dr. Rodriguez from the NYU Langone Medical Center. Of the estimated 20 partial and full face transplants since 2005, between three and five patients have died after new tissue was rejected. Transplant Picture | Face Transplants, Then and Now - ABC News ABC News Face Transplants, Then and Now + − Transplant This picture shows French woman Isabelle Dinoire on Nov. 1, 2006, one year after her facial transplant surgery. She is wearing makeup in this photo. Doctors in Amiens, France, performed the transplant on Dinoire after she was mauled by her dog and lost much of the flesh on her lower face. The New England Journal of Medicine Pakistan Domestic Violence WARNING: Some of the following pictures are of a graphic nature. Viewer discretion is advised. ABC News Man Steps Out After Face Transplant Poland's first face transplant recipient has been discharged from the hospital just 11 weeks after the life-saving surgery.

The 33-year-old man, identified only as Grzegorz, received the transplant three weeks after losing his nose, upper jaw and cheeks in a workplace accident. Tomasz Griessgraber/AP Photo Man Saved by Face Transplant Polish doctors say they saved a man's life by performing a face transplant just three weeks after he was severely maimed in a workplace accident. Cancer Center and Institute of Oncology/AP Photo Man Saved by Face Transplant Richard Norris speaks with a psychiatrist during a visit to the University of Maryland Medical Center in Baltimore, June 18, 2013. In the 15 years between a shotgun blast that ravaged the bottom half of Norris' face and the face transplant -considered the most extensive face transplant performed to date - Norris faced cruelty from strangers, fought addiction and contemplated suicide. Patrick Semansky./AP Photo Man Saved by Face Transplant Richard Norris speaks with Dr. Eduardo Rodriguez, who led the surgical team that performed Norris' face transplant, during a visit at the University of Maryland Medical Center in Baltimore, June 18, 2013.

Norris is now starting a new life with the hope that his path will send a message of hope to people in similar situations and encourage empathy in others. Patrick Semansky./AP Photo Man Saved by Face Transplant University of Maryland Medical Center doctors E. Albert Reece, Stephen T Bartlett and Eduardo D. Rodriguez explain the most extensive full face transplant completed to date performed on Richard Lee Norris, pictured, during a news conference, March 27,2012, at the University of Maryland Medical Center in Baltimore. Gail Burton/AP Photo Face Transplant Patient's Transformation Richard Lee Norris, 37, said he's no longer a recluse after receiving a full face transplant at the University of Maryland Medical Center seven months ago. "People used to stare at me because of my disfigurement," he said. "Now they can stare at me in amazement and in the transformation I have taken." University of Maryland Medical Center Face Transplant Patient's Transformation Carmen Blandin Tarleton, of Thetford, Vermont, speaks with reporters at Brigham and Women's Hospital in Boston, on May 1, 2013.

The 44-year-old mother of two underwent the transplant in February after a 2007 attack in which her estranged husband doused her with industrial strength lye, burning more than 80 percent of her body. Charles Krupa/AP Photo Face Transplant Patient's Transformation Carmen Blandin Tarleton, 44, is seen here after being doused in lye by her estranged husband, she recently received a face transplant . Courtesy Brigham and Women's Hospital Face Transplant Patient's Transformation Carmen Blandin Tarleton, 44, received a face transplant after being doused in lye by her estranged husband. Courtesy Brigham and Women's Hospital Dallas Wiens' New Face At a Monday press conference, Dallas Wiens, 26, discussed his life with a new face one year after receiving the first full face transplant in the United States. Wiens suffered life-threatening burns to his head when a boom lift he was driving drifted into a power line in 2008. In March 2011, doctors at Brigham and Women's hospital in Boston worked for more than 17 hours to give him a new face.

ABC News Dallas Wiens Before and After Dallas Wiens, before and after, the full-face transplant procedure performed at Brigham and Women?s Hospital in March 2011. Parkland Health and Hospital System|Lightchaser Photography Chimp Victim Charla Nash's New Face Charla Nash after her injuries and after her face transplant. Brigham and Women?s Hospital|Lightchaser Photography Chimp Victim Charla Nash's New Face Charla Nash before her accident. Courtesy Nash Family Mitch Hunter Before and After Mitch Hunter, 30, before and after his full-face transplant. Courtesy Hunter Family|Lightchaser Photography Face Transplant This photo shows Connie Culp prior to September 2004, before she was shot in the face by her husband, Thomas Culp. The shotgun blast left her disfigured, smashing her nose, cheek and jaw. It also led to Culp becoming the country's first-ever face transplant recipient. Courtesy Cleveland Clinic Face Transplant The first step for surgeons was to determine the borders of the area that they would remove from Culp's face to create a space for the facial tissues of a deceased donor.

Surgeons decided that the damage from Culp's injury called for the replacement of about 80 percent of her face. ABC Face Transplant Once incisions had been made around the periphery of the operating area, surgeons had access to the muscles, blood vessels, bones and other tissues of Culp's face. But removing the skin was only a preliminary step in the extensive face-transplant procedure. ABC Face Transplant The face transplant was more than skin deep. In past operations, surgeons had crafted a makeshift upper jaw and teeth using bone tissue from other areas of Culp's body -- shown here in purple. To make room for the donor tissues, one of the surgeons' first jobs was to remove this previous work. ABC Face Transplant Once the improvised jaw and teeth had been removed -- as well as some extra cartilage -- Culp was left with a large gap in the middle of her face. Once the surgeons had a blank canvas with which to work, they could begin the delicate procedure to reattach the donor facial tissues to the front of Culp's head. ABC Face Transplant The midface from the deceased donor is seen here.

Along with the facial skin, surgeons also had to transfer the muscles, nerves, blood vessels and bones in order to achieve a face that would be both aesthetically acceptable and functional. ABC Face Transplant Once the original face had been removed and the graft was available, it was time for the surgeons to start attaching the donor face. The transfer started at 5:10 a.m., and the surgeons knew it would take an additional two hours and 40 minutes to connect the blood vessels of the donor face to Culp's own blood vessels. ABC Face Transplant Once surgeons meticulously connected blood vessels from Culp to blood vessels in the donor face, circulation to the graft tissues was restored. Doctors say this was the "most critical" time of the surgery that could determine whether Culp's body would accept or reject the new face. ABC Face Transplant Perhaps the most delicate part of the procedure, the attachment of tiny nerves and the smaller blood vessels from the donor tissues to Culp's face was a microsurgical feat. The donor tissues would have quickly died if they had not received a proper supply of blood, and the proper reattachment of nerves was necessary if surgeons hoped to restore a modest degree of muscular function to the new face.

ABC Face Transplant As surgeons worked to connected blood vessel to blood vessel, they watched to see whether blood would begin to flow into the new transplant. When Culp's blood reached the new face, there was an immediate possibility the blood could reject the tissue as foreign and attack it instead of accepting the donor face as part of her body and nourishing it. ABC Face Transplant As the surgery reached its completion, doctors saw the new donor face turn pink, signaling that the connections between blood vessels had been successful and that Culp's body was accepting the new tissue. ABC Face Transplant The CT scan on the left shows the front of Culp's skull following her facial injury. The shot that she took to her face shattered her nose, cheekbone and jaw. The CT scan on the right is the same view of Culp's skull following her face transplant operation. Surgeons used the facial bones of a deceased donor to reconstruct nearly all of the middle of Culp's face. Courtesy Cleveland Clinic Face Transplant Culp before and after her surgery. While doctors are still waiting to see how much function Culp will regain as the nerves in the graft continue to regenerate, Culp said that she is already pleased with the results.

The surgery has drastically improved her quality of life, doctors said, as she can now eat all solid foods, drink from a cup, and smell and breathe on her own through her nose. Courtesy Cleveland Clinic Face Transplant This computer-retouched image projects what Culp will look like after her full recovery, once the swelling from her surgery has completely subsided. While doctors say Culp will enjoy a much more normal life thanks to the surgery, she must also maintain a daily regimen of powerful immunosuppressant drugs in order to prevent her body's immune system from rejecting the donor face. Courtesy Cleveland Clinic Jim Maki Face Transplant James Maki, 59, the second U.S. patient to receive a face transplant, before the operation. Maki sustained severe burn injuries to his face and right arm in 2005 when he fell onto an electrified rail at a Boston subway platform. Dr. Bohdan Pomahac, at Brigham and Women's Hospital in Boston, said that when he initially saw Maki immediately after the accident, he did not know whether the man would survive.

Courtesy Brigham and Women's Hospital Jim Maki Face Transplant After his accident, Maki's injuries were initially repaired by stretching skin from his cheeks to cover the part of his face that had been burned away when he fell on an electrified subway rail. Maki said his appearance after the first round of surgeries was socially problematic, as many were repulsed by his appearance. Courtesy Brigham and Women's Hospital Jim Maki Face Transplant An artist's drawing of Maki's injuries after the accident. The burns Maki sustained destroyed his nose, upper lip, cheeks, his right lower eyelid and the roof of his mouth. Many of the nerves, muscles and bones underneath the skin of his face were also destroyed. The face transplant was performed April 9, 2009, led by Dr. Bohdan Pomahac of Brigham and Women's Hospital in Boston. Courtesy Brigham and Women's Hospital Jim Maki Face Transplant An artist's drawing of Maki's injuries after the accident. Even after Maki had lost much of his face in the accident, surgeons still had to remove damaged tissue around the wound. They also had to perform surgery to close the gap between his mouth and nasal cavity so that he could eat.

Courtesy Brigham and Women's Hospital Jim Maki Face Transplant Susan Whitman-Helfgot, left, meets with Maki. Maki's face transplant was made possible by Whitman-Helfgot's decision to donate her husband's face when he died last month. Courtesy Brigham and Women's Hospital Jim Maki Face Transplant Whitman-Helfgot embraces Maki after they met for the first time. During a Thursday press conference, Maki expressed his gratitude to Whitman Helfgot, who allowed her deceased husband's face to be made available to transplant to Maki. Courtesy Brigham and Women's Hospital James Maki,second person in the world to undergo a face transplant Maki is shown here after his procedure. Despite the complexities of medical care following his face transplant procedure, Maki experienced only two minor instances of rejection which doctors successfully treated with steroid medication. <p> For more photos <a href="">click here</a>. WCVB Face Transplant French doctors in the medical journal The Lancet describe a major facial transplant for a 29-year-old man with disfiguring tumors. So far, doctors are calling the 2007 surgery that replaced most of the man's face a success.

The young man can communicate better and has not rejected the donor's facial tissue. The Lancet Face Transplant Severe facial injuries or damage by tumors often mean a reconstructive surgeon must take into account vital structures in the face. Facial transplants go beyond simple plastic reconstruction to using living donor tissue. The Lancet Face Transplant A Chinese farmer who confronted a bear trying to attack his cows ended up needing extensive reconstructive surgery. Now his doctors are showcasing the progress of his rarely performed facial transplant in the medical journal The Lancet. The Lancet Face Transplant After losing nearly half his face to a bear attack, this patient has made remarkable progress thanks to a new type of reconstructive surgery. The facial transplant included connecting arteries and veins and repairing his nose, lip and sinuses. The Lancet Face Transplant Shortly after his face transplant, this man faced the danger that his body would reject donor tissue and attack it as a disease. His doctors gave him four different drugs to control his immune system and other drugs to combat infections, which were tailored to the bacteria found on swabs of his nose and throat.

The Lancet Face Transplant Not only did doctors reconstruct the tissue from one 30-year-old man's face after a bear attack, they also needed to reconstruct facial bones underneath. Two years after his 2006 surgery, the farmer is reportedly doing well. The Lancet Transplant This picture shows French woman Isabelle Dinoire on Nov. 1, 2006, one year after her facial transplant surgery. She is wearing makeup in this photo. Doctors in Amiens, France, performed the transplant on Dinoire after she was mauled by her dog and lost much of the flesh on her lower face. The New England Journal of Medicine Transplant This photo, taken in June 2007, shows Dinoire without makeup 18 months after her surgery. Though the scars from the operation are still visible, surgeons are pleased with the result. More important, doctors say that the danger of Dinoire's body rejecting the transplant is largely over. The New England Journal of Medicine Transplant This photo, taken in June 2001, shows what Dinoire looked like four years before the dog attack that disfigured her face.

The New England Journal of Medicine About Face: Transplant Patient Up Close The image here shows the large number of muscles, nerves and blood vessels that surgeons had to take into account when performing Dinoire's partial face transplant. Many doctors have since said that the sheer complexity of the operation, combined with its possibility for complications, makes it an impractical choice for many patients. Courtesy New England Journal of Medicine Face Transplant Dinoire met with a number of doctors in the months before her surgery. Her injury occurred while she was sleeping. Dinoire woke up to find that, while unconscious, her nose and lips had been bitten off by her black Labrador -- which was ultimately euthanized. It was only when she attempted, in vain, to smoke a cigarette that Dinoire realized she was without half a face. ABC Face Transplant She could barely speak or eat. The muscles of her cheeks were no longer anchored to those around her lips. Doctors suggested a partial transplant, and despite the risks, Dinoire immediately agreed. ABC Face Transplant Dinoire waited five months for a matching donor with the right tissue, compatible color and quality of skin.

During the waiting time, Dinoire wore a mask to cover the lower half of her face much of the time. In these months, doctors had to make sure Dinoire took part in intensive physical therapy to stem the hardening of her muscle and tissues. ABC

Question: French woman Isabelle Dinoire was the first person to receive a transplant of which body part in 2005?
Answer: Face