Face Transplant a Smiling Success

Med Headlines - Eighteen months ago, Isabelle Dinoire became the first person ever to have a partial face transplant, following an attack by her dog, which left her with such severe facial injuries there was little hope for her survival. Lead surgeon Jean-Michel Dubernard, MD, PhD, and his colleagues at the University of Lyon in France, reports in the December 13 issue of the New England Journal of Medicine that Dinoire’s appearance is almost normal and facial function is nearly complete. face transplant

To repair Dinoire’s injuries, surgeons had to amputate the tip of her nose, her chin, both lips, and parts of her cheeks. The injuries were so extensive that standard methods of plastic surgery would be ineffective.

The donor, a brain-dead woman of 46, had the same blood group and 5 HLA antigens as Dinoire.

Dinoire’s recovery after this groundbreaking surgical procedure has been remarkable.

She was able to eat and drink with near normal ability just a week after surgery and sensation to the transplanted portion of her face was normal after only six months.

After 12 weeks, Dinoire regained partial control of her upper lip and control of the lower lip came in the fourth month. Full closure of the lips occurred six months after surgery.

Control of movement to the nose and chin muscles came about a year after surgery.

Her smile has grown gradually, starting rather crooked at 10 months, becoming more normal at 14 months, and fully normal at 18 months after surgery.

Medical side effects to Dinoire’s recovery have included two episodes of rejection and a bout of impaired kidney function. All episodes were quickly controlled.

Dinoire will be required to take medications to prevent rejection of the transplanted tissue for the remainder of her life.

Filed under: Transplant Medicine