Face transplant near total

Work at hospital in Cleveland is the most extensive

Doctors who took part in the nation's first near-total face transplant, at a Cleveland Clinic news conference. Doctors who took part in the nation's first near-total face transplant, at a Cleveland Clinic news conference. (Associated Press Photo / Tony Dejak)
By Marilynn Marchione
Associated Press / December 18, 2008
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CLEVELAND - A woman who had suffered severe facial trauma got essentially a whole new face in a first-of-its-kind operation at the Cleveland Clinic, hospital officials said yesterday.

Only the woman's upper eyelids, forehead, lower lip, and chin were left - the other 80 percent of her face was replaced with one donated from a female cadaver during the 22-hour surgery about two weeks ago.

It was the nation's first face transplant and the fourth worldwide, though the others were not as extensive as this one.

The patient's name and age were not released, nor details on how she was injured. Her injuries were so horrific that she lacked a nose and palate and could not eat or breathe on her own without a special opening into her windpipe.

After the transplant, "I must tell you how happy she was when with both her hands she could go over her face and feel that she has a nose, feel that she has a jaw," said the lead surgeon, Dr. Maria Siemionow.

The woman is doing well and showing no signs of rejecting the new face, doctors said.

It is the first facial transplant known to have included bones, along with muscle, skin, blood vessels, and nerves.

The woman received a nose, most of the sinuses around the nose, the upper jaw, and even some teeth, said Dr. Frank Papay, the clinic's plastic surgery chief.

"This patient exhausted all conventional means of reconstruction and is the right patient," Siemionow said at a news conference.

So many disfigured patients are stuck "in their houses who are hiding from society," afraid to go out, she said.

"Our patient was called names and was humiliated," she said. "You need a face to face the world."

The face was donated by a family that was asked specifically to approve the gift - not simply done under general organ donation consent rules, said officials of LifeBanc, the Northeast Ohio organ procurement group that arranged the transplant.

The recipient was not shown a picture of the donor, and in animal experiments, "the recipient never looks like the donor," especially when the injuries are so severe, Siemionow said.

The hospital posted a statement from the woman's sibling on its website.

"We never thought for a moment that our sister would ever have a chance at a normal life again, after the trauma she endured," it says. "But thanks to the wonderful person that donated her organs to help another living human being, she has another chance to live a normal life. Our family cannot thank you enough."

The hospital's bioethics chief, Dr. Eric Kodish, said the ethical and psychological issues surrounding the donation and consent were "beyond reproach."

"This is not cosmetic surgery in any conventional sense," Kodish said.

"The surgery took 22 hours. The preparation to the surgery took over 20 years," Siemionow said.

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