Face Transplant Patient Smoking Again

With her surgeons at her side, the French face transplant patient looked at the cameras and introduced her new face -- her new identity -- to the world for the first time.

"I have a face like everyone," Isabelle Dinoire said. "For several days, I can feel my lips, nose and mouth. A door is open for the future for me and many others I hope."

Dinoire, 38, is taking small but miraculous steps. Her lips are still partially paralyzed, and she can't yet smile or frown. She doesn't like that her doctors won't let her wear makeup -- they believe it could cause an infection -- but she said that as she regained feeling in her mouth, she's enjoying eating again, favoring strawberries and French red wine. Her doctors accept but don't approve that she's smoking again as well -- which is harmful because it cuts off oxygen to the transplant area.

In November, a team of French surgeons made her the first person in the world to undergo a partial face transplant. They attached the nose, lips and chin of a deceased donor to replace features torn away when her pet dog mauled her while she slept.

Last month, Dinoire's French surgeons, Bernard Devauchelle and Jean-Michel Dubernard, presented Dinoire's case for the first time in scientific detail at an international meeting of transplant surgeons in Tucson, Ariz. They showed photographs and videotape of the procedure, and reported that Dinoire had passed through the streets unnoticed (despite extensive scarring) on two separate outings from the hospital. Doctors in France are now seeking permission to perform five new face transplants.

Now that they have seen the results after two months, many doctors are singing the praises of the team that operated on Dinoire.

"Impressive results, better than I would have anticipated," said Dr. Peter Costantino of St. Luke's-Roosevelt Hospital Center. "Very good tissue integration."

But she still has some visible scars that Costantino said would fade but never disappear, and her bottom lip droops because Costantino said the motor nerves were slower to recover.

"I understand all people who suffer from handicaps, whatever they are," Dinoire said. "I hope my operation will be able to help them. I know I can live again."

Doctors say Dinoire has been making remarkable strides. She has been walking the streets of her hometown, Valenciennes, but has to be extremely careful: Even a tiny scratch and a little bit of dirt could cause serious damage to her face.

The most pressing issue is that of tissue rejection. Dinoire has already suffered a bout with rejection, and it will always be a risk that her body will not accept the new tissue. But Costantino said the French team had minimized the risk for now.

"They do have it under control now," he said. "What will happen in the future is unclear. Long term, she is going to have to be monitored for rejection."

But Costantino said Dinoire could live a normal life.

"That's the point of the transplant," said Costantino, who is hoping to do a face transplant soon. "It's not practical and it's not necessary to keep her locked up."

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