MADRID — A team of surgeons has carried out the world’s first full-face transplant on a young Spanish farmer unable to breathe or eat on his own since accidentally shooting himself in the face five years ago.
It was the most extensive operation yet and the 11th known face transplant worldwide.
During the 24-hour surgery, doctors lifted an entire face, including jaw, nose, cheekbones, muscles, teeth and eyelids, and placed it masklike onto the man, said Dr. Joan Pere Barret on Friday.
Transplant experts hailed the surgery, carried out late last month at Barcelona’s Vall d’Hebron Hospital, as a significant advance.
“It is a breakthrough. They are pushing the envelope, and I am very happy for them,” said Dr. Thomas Romo, chief of facial and reconstructive surgery at Lenox Hill Hospital in New York.
The Spanish patient, who was not identified, has a completely new face from his hairline down and only one visible scar, which looks like a wrinkle running across his neck, said Barret, who headed the 30-member surgical team.
The man cannot yet speak, eat or smile, but he can see and swallow saliva, the surgeon said. He is expected to be able to eat and breathe on his own in about a week.
“If you look him in the face, you see a normal person,” Barret said. “He sits up, he walks in his hospital room and he watches television.”
Before the transplant, the 30-year-old patient had had nine surgeries and could only breathe with the help of a ventilator and get nourishment from a feeding tube. He also had problems speaking.
The 2005 accident, in which he shot himself with a shotgun, essentially destroyed his face from the eye sockets down, although his eyes and eyesight were unaffected.
Romo said the patient and doctors are euphoric now, but even three years from now the body could reject the face.
Unlike operations involving vital organs like hearts and livers, transplants of faces or hands are done to improve quality of life — not extend it. Recipients run the risk of deadly complications and must take immune-suppressing drugs for the rest of their lives to prevent organ rejection, raising their odds of cancer and other problems.
Surgeons say most recipients believe the risk is worth it.
Prior procedures
There have been 10 partial-face transplant operations worldwide, including:
• The world’s first partial-face transplant was done in France in 2005. The 38-year-old woman, who had been mauled by a dog, had a nose, lips and a chin grafted onto her face.
• A near-total face transplant was carried out in 2008 in Cleveland, Ohio, on a woman who was shot in the face. During the 22-hour procedure, 80 percent of her face was replaced. It was the first such transplant for a person from the United States.
