Surgeons at the Cleveland Clinic today described the marathon, 22-hour procedure they performed to transfer 80 percent of a face -- including eyelids, bone, teeth and a nose -- from a cadaver to a living female patient, giving her a chance at a more normal life.
The surgery, a first for the United States, took place sometime in the past couple of weeks and repaired the face of a female patient using facial tissue from a dead female donor. It is the world's fourth face transplant operation, and it may well be the most extensive such surgery yet to take place.
Hospital officials released scant details on the patient, citing a desire by the patient and her family to remain anonymous.
Reconstructive surgeon Dr. Maria Siemionow, who led the team of eight surgeons that performed the operation, indicated at a press conference Wednesday afternoon that the operation was intended to correct "major facial trauma" the patient sustained several years ago that left her missing "major parts of her face."
Siemionow revealed that the trauma had caused the patient to be blind in one eye, and she had lost both her sense of smell and sense of taste to the injury. It also caused her trouble in speaking.
"This patient exhausted all conventional means of reconstruction and was the right patient," Siemionow said. "The patient was really suffering whenever she appeared in social situations. She was called names, children were running away from her; they were afraid."
Thus far, doctors said, the patient appears to be recovering smoothly. No experimental drugs were used in the procedure, and there are no signs of rejection.
And though it will take weeks for the patient to complete her recovery, doctors said that the woman has already seen her new face in a mirror. They added that she has also used her hands to gently feel her new face and is excited to have a nose.
The effort itself was years in the making, Siemionow said. It was based on 20 years of research and had actually been approved by the hospital's internal review board in late 2004.
And the surgery was extensive. The operation involved the transfer of nearly all of the front of the face, including the lower eyelids, cheekbones, the entire nose and the upper jaw, including some teeth.
Until three years ago, face transplants existed solely in the realm of science fiction. That changed in November 2005 when Frenchwoman Isabelle Dinoire became the first recipient of a partial face transplant.
Since then, two similar operations have taken place. In April 2006, Chinese surgeons replaced part of the face of a farmer who had been attacked by a bear, and in January 2007 another team of French doctors repaired the face of a man who had suffered a disfiguring facial condition.
But while medical experts across the board agree that the nation's first facial transplant is cause for excitement, they remain split on the likelihood that such procedures could one day become routine.
Dr. John Canady, professor of plastic surgery at the University of Iowa and president of the American Society of Plastic Surgery, said cases would have to clear a high bar in order to be considered for the complex and still largely experimental procedure.