Doctors Describe First U.S. Face Transplant

Dec. 18 -- WEDNESDAY, Dec. 17 (HealthDay News) -- A team of eight Cleveland Clinic surgeons has completed the nation's first near-total face transplant.

Surgeons replaced most of the woman's face, including about 80 percent of the skin surface of her face, total nose, most of the sinuses, upper jaw -- essentially everything except the upper eyelids, forehead, lower lip and chin -- with that of a deceased donor in an immensely complex procedure taking place just weeks ago.

"We have finally done it," said Dr. Maria Siemionow, director of plastic surgery research and head of microsurgery training at the Cleveland Clinic, who led the team. "This procedure went well according to the plan, and the patient is doing well. The surgery took 22 hours. The preparation to the surgery took about 20 years of work in the field of composite tissue transplantation."

Siemionow and other members of the team spoke at a Wednesday teleconference, punctuated by thunderous applause from the audience and pleas from members of the surgical team to respect the privacy of the recipient and the donor.

The patient, identified only as a female and a U.S. citizen, had suffered a major facial trauma in the middle of her face so that multiple parts of her face were missing, including skin, bone, nose, eyelids, upper lid, right eye. She could not smell and had trouble speaking and could not eat or breathe without a tracheostomy.

"She was really suffering whenever she appeared in a social situation, was called names, children were afraid of her, were running away. The patient was brave, and she was very stable and facing the world. However, it became very difficult for her just to go outside of her house," Siemionow said.

Doctors would not disclose what kind of trauma was responsible for the disfigurement, only that the patient had exhausted all existing, conventional procedures, a condition for eligibility for the rare procedure.

Although this is the first such procedure in the U.S., 38-year-old Isabelle Dinoire successfully underwent a partial-face transplant in France in 2005, after being mauled by her dog. Since then, two other face grafts have been performed, one in China in 2006 and another in Europe in 2007.