Woman is grateful after world's first face transplant
After undergoing a 24-hour operation, the first woman successfully recovered from partial face surgery. The operation had stirred debate among scientists over ethics. Some have questioned that traditional reconstructive surgery would have been the best choice, while others were concerned about the woman's psychological health.By EMMA ROSS
The Associated Press
LYON, France , Dec. 2 -- A woman who underwent the world's first partial face transplant regained consciousness 24 hours after the groundbreaking operation, and her first words were "thank you," one of her doctors said Friday. The 38-year-old woman, whose identity has not been disclosed, was mauled by a dog in May. She underwent the transplant Sunday at a hospital in Amiens, northern France. The donor was a brain dead woman.
This image released by the Lyon Hospital Friday, Dec. 2 shows the three-dimensional model of the reconstruction of the nose, lips and chin in the first partial face transplantation. (AP Photo/CHU Lyon)The operation was done by Dr. Jean-Michel Dubernard and Dr. Bernard Devauchelle.
"There were no post-surgical problems," Devauchelle said at the doctors' first news conference. Behind him were projected images of the facial portions that were transplanted _ a section of the nose, lips and chin.
"The patient was awake at the 24th hour and ... her first word was 'merci,'" Devauchelle said.
Hospital director Philippe Domy said the surgery was required because "we are in an exceptional situation that required an exceptional response."
The woman's severe facial injuries had made it difficult for her to speak and eat, her doctors said.
Dubernard acknowledged that he had initial reservations in the planning stages of the surgery, but he added that when he saw the extent of the woman's disfigurement, "I no longer hesitated for a second."
Carine Camby, director-general of the agency under the French health ministry that coordinates organ procurement said the woman was warned that she risked becoming a center of media attention because the surgery was a world's first.
The operation has set off a debate among scientists over ethics. One surgeon questioned the procedure, saying traditional reconstructive surgery should have been tried first. Others raised concerns over her psychological health.
Dr. Laurent Lantieri, an adviser to the French medical ethics panel, said the surgeons violated the panel's advice because they failed to try reconstructive surgery first.
The panel had previously objected to full face transplants but said partial ones could be considered under strict circumstances, which included first trying normal surgery.
However, surgeon Denys Pellerin, of the National Consultative Ethics Committee advised by Lantieri said, "as long as the transplant is not total, it is not unethical."
And Dr. Jean-Pierre Chavoin, secretary general of the French society of plastic surgery, noted that Lantieri had planned to do a face transplant himself but was beaten to it.
Camby said normal reconstructive surgery could not have been used in this case.
"It is precisely because there was no way to restore the functions of this patient by normal plastic surgery that we attempted this transplant," Camby said. "She could no longer eat normally, she had great difficulty speaking and there is no possibility with plastic surgery today to repair the muscles around the mouth which allow people to articulate when they speak and not spit out food when they eat."
However, a surgeon involved in the advance evaluation of the case suggested traditional techniques may not have been impossible.
"We could have tried (reconstructive surgery). ... The aesthetic result would have been average. ... This was the search for a better functional and aesthetic result," said Dr. Guy Magalon, director of plastic and reconstructive surgery at Conception Hospital in the southeastern city of Marseilles. He was the consultant on reconstructive surgery to the French Agency of Health Security and Products for a review panel it convened in June to look at the graft proposal.
Chavoin, who took part in preparatory meetings about the patient's case over the last several months, was one of a few doctors who questioned the woman's psychological health Thursday.
The patient "seems to have quite a depressive profile," he said. It was unclear whether he was referring to the woman's state of mind before the dog bite or afterward.
However, Magalon appeared to defend the patient's psychological suitability for the surgery.
"There was a psychological review indicating that she would be able to withstand this operation. After that, nobody is infallible," he said.
Camby also said the patient "received many psychiatric examinations. The psychiatrists decided that she understood the surgery and that she accepted all of the consequences, including the risk of rejection and of failure, the risk of immune suppression treatments and the need to take them for life."
Dubernard led teams that performed a hand transplant in 1998 and the world's first double forearm transplant in January 2000.
The hand transplant recipient later had it amputated. Doctors said the man failed to take the required drugs and his body rejected the limb.
Lantieri said he feared this operation could turn out like that first hand transplant if the patient is psychologically unstable.
Story Produced by: Jessica Phillips
