Face Transplant Patient Can Smell, Taste, Breathe Normally

Nov. 18 -- TUESDAY, Nov. 17 (HealthDay News) -- The woman who underwent the first facial transplant in the United States can now smell, taste what she eats and breathe through her nose, according to a report from her surgeons.

Nearly a year after the surgery, blood vessels from the transplanted tissue have integrated with existing tissue, she has had no significant complications and her sensory and motor abilities, including the ability to speak, continue to improve, they say in the November/December issue of the Archives of Facial Plastic Surgery.

"This really does open up new frontiers both for transplanting more of the face and for offering it to individuals with previous reconstructive failures," said Dr. Wayne Larrabee, Jr., a clinical professor of head and neck surgery at the University of Washington in Seattle and editor of the journal.

Connie Culp, a mother and grandmother from Unionport, Ohio, was shot by her husband in a failed murder-suicide attempt in 2004. The shotgun blast destroyed the middle part of her face, including her nose and nasal passage, upper jaw and cheeks, and she lost her sight.

Though there were three face transplants performed worldwide before Culp's -- and a total of about seven to date -- Culp's "near-total" face transplant was among the most extensive ever performed. The surgery replaced much of the soft tissue of her face, the bony structure of the palate (roof of the mouth) and her upper jaw.

Making the surgery even more challenging, the transplant was a "salvage operation," done after Culp had endured 23 failed attempts at reconstructive surgery. The earlier operations caused extensive scarring and destroyed blood vessels, further complicating an already difficult task.

"This patient had undergone multiple previous procedures for reconstruction which had failed," Larrabee said. "This made the surgery much more difficult but the ethical decision very clear."

Last Dec. 9, eight surgeons from the Cleveland Clinic replaced 80 percent of Culp's face and jaw during a 22-hour operation. The donor was a woman who had been pronounced brain dead and was a match for Culp's age, race and skin complexion. The new face included the nose, upper lip, lower eyelids, upper jaw, incisor teeth, palate and various glands, as well as bones and ligaments. Culp, then 46, was given immunosuppressant drugs to prevent rejection.