Surgeons face off to perform first whole-face transplant

By SCOTT MacLEOD

Surgeons are racing to be the first to swap a face from a dead person to a live one.

At least five teams of surgeons - in France, Britain and the United States - are preparing for the transplants in a move that would turn the Hollywood film Face/Off into reality.

Reports in Britain say the first patient will be a girl disfigured by fire. Newspapers are said to have offered up to $750,000 for the story, with "before and after" photographs.

The idea comes from a growing belief among surgeons that transplanting a face would be easier than continuing with painstaking grafts of tissue from other parts of an afflicted person.

Irish plastic surgeon Peter Butler is among the specialists pioneering the idea of facial transplants, in which a patient undergoes at least 10 hours of surgery to receive new skin, bone, lips, a chin, ears and a nose from the donor.

Britain's Independent newspaper reported that 10 people with wrecked faces had approached Mr Butler since he published a research paper last year saying face transplants were feasible.

He told one newspaper that the recipient would look different to the donor because their bone structures were not the same.

"The technology is there - the biggest obstacle is public opinion and funding."

But the move has sparked an ethical debate about the patient's ability to survive the psychological shock of such a transplant.

A professor of medical ethics at Otago University, Grant Gillett, said there were more ethical problems with a face swap than with other forms of transplant.

Evidence suggested that people with transplanted organs took on some habits and personality traits of the donors, such as food tastes.

"The thought is that tissues carry an important part of a person's being, and a face transplant could possibly have a profound effect on self-image, which we know is very important for human beings in terms of defining who they are."

Professor Gillett alluded to Face/Off, in which characters played by Nicolas Cage and John Travolta swap faces and are treated differently by people in their lives.

"It's the whole idea of incorporating into your self-being the significant influence of somebody else."

A professor of health and social ethics at AUT, David Seedhouse, said there were good arguments in favour of face-swapping if it could help disfigured people.

Equally, many people had religious and ethical objections.

New microsurgical devices, coupled with better anti-rejection drugs, have brought the transplant closer to reality.

Eight blood vessels must be removed from the donor. Another team of surgeons would remove, or "de-glove", the face, facial muscles, skin and subcutaneous fat.