The Telegraph
Since 1st March, 1999
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Face transplant race
- British, American doctors in pursuit

London, Oct. 25: In a medical breakthrough, a British surgeon was today given the go-ahead by an ethics committee to perform the world’s first full face transplant “within a year”.

Now Irish-born consultant surgeon Peter Butler, 44, who is based at Royal Free Hospital in Hampstead, north London, is in a race against American doctors at the Cleveland Clinic in Ohio who are also selecting patients for surgery in a bid to be the first to achieve almost a medical miracle.

The new techniques will take further the partial transplant performed in November last year in France on 38-year-old Isabelle Dinoire, who received a section of a nose, lips and chin after being mauled by her pet Labrador.

Her replacement face was taken from a woman of 46 who died from severe loss of blood to the brain and was technically “brain dead” when the transplant was performed.

Cinemagoers in India who have seen the remake of Don will know how the baddie played by Shah Rukh Khan is replaced, when critically injured, by lookalike “Vijay”, also portrayed by Shah Rukh.

Leaving aside the complication that the switch is switched back, in the future, criminals who want to evade capture can look forward to a complete change of face.

The new one will have to come from a dead person, of course — no marks for guessing how donors in Bollywood movies will be encouraged to “donate” their faces.

In real life, medical science is about to take a giant leap forward in London.

Butler, who has been granted permission for the pioneering surgery by the ethics committee at the Royal Free Hospital, said he had been researching the plan for years.

“I feel delighted that we have got the go-ahead,” he said. “It’s been a long journey but this is just the beginning, really. The most important part of the process starts now, which is selection of the patients.”

His team has been approached by 34 patients from all over the world but he said he wanted more people to come forward now that approval has been granted. His team will choose four patients from the UK or Ireland for staged operations, possibly six months apart.

In order to qualify, patients will have to have faces almost entirely disfigured by injury, such as severe burns.

Butler said he hoped the operation could be performed “within a year” and insisted it was not a race, but it will be seen as such.

However, before the scriptwriters of Bollywood or rich criminals of the world break open champagne bottles, medical experts are warning that the surgery is at an early stage.

It is being pointed out that such an operation has never been performed before and the risks to a patient are high. Problems include increased chance of cancer, the possibility of shortened life expectancy and high likelihood that the body will reject the new skin.

Robert Page, president of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, said: “It is a question of balance, if you do not have a face and you have this operation done, a number of things may happen to you. It may reduce your lifespan, but your quality of life overall may be significantly improved. This is the difficulty — it is all about risk and benefit. The psychology surrounding the operation is very important.”

Changing Faces, a national charity supporting people with disfigurement, also expressed concern about today's decision.

Spokeswoman Winnie Coutinho said: “We are not against facial transplants per se. There are considerable risks attached to the procedure with the risk of cancer, shortened life expectancy and if there is rejection, what is plan B'”

Butler began his work on the pioneering technique almost 15 years ago, developing it into a clinical programme at the Royal Free over the last five years. As head of the UK Facial Transplant Team, he has been waiting many months for today’s green light. Some critics have called him a maverick, a freak, bonkers or nuts, but his determination has never waned and he is regarded as a man with a mission.

Similar worries were expressed when Professor Christian Barnard carried out the world’s first heart transplant — now considered almost routine — in South Africa in 1967.

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