A 38-year-old French woman who underwent a partial face transplant after being mauled by her dog is eating, drinking, and even smiling 18 months after the landmark surgery.
The surgery was the first ever partial face transplantation and, as such, continues to break new ground, both medically and ethically. In the Dec. 13 issue of the New England Journal of Medicine, the surgeons who performed the operation report on the woman's progress.
The patient, Isabelle Dinoire (pictured today without makeup), was attacked by her dog in May of 2005, resulting in the amputation of part of her nose, both upper and lower lips, her chin, and parts of both cheeks.
Jean Michel Dubernard and his team grafted a nose, lips, and chin onto the woman's face on November 27, 2005, in Amiens, France. The donor was a brain-dead, 46-year-old woman with the same blood type as the patient.
Although a face transplant is not technically a lifesaving procedure, recipients still need to take immunosuppressant drugs to prevent rejection, as this woman did.
Forty-eight hours after surgery, the patient started physical therapy involving facial exercises focusing on lip movement and closing her mouth. She also received psychological support.
By the end of the first week post-surgery, the woman was able to eat and drink almost normally, her doctors reported. There was some initial leakage from her mouth but this was resolved by the end of the year.
The woman also regained sensitivity to light touch and to heat and cold.
Recovery of motor functions was slower, but, by the end of the 12th week following surgery, the woman could partially move her upper lip. She regained the ability to move her lower lip after the fourth month. And she was able to completely close her mouth 10 months after surgery, improving her ability to pronounce words and letters.
The woman's smile remained lopsided up to the 10th month after surgery but was normal at 18 months.
The patient did experience two rejection episodes, both of which were successfully reversed. There were also two infectious complications, both of them were also resolved.
According to the New England Journal of Medicine report, by the end of the fourth month after surgery, "the patient was capable of facing the outside world and gradually resumed a normal social life. . . At present, the patient says she is not afraid of walking in the street or meeting people at a party, and she is very satisfied with the aesthetic and functional results."
Illustration: New England Journal of Medicine.
US News & World Report (12/12/07)
MedPage Today (12/12/07)
Scientific American (12/12/07)
LA Times (12/13/07)
Washington Post (12/13/07)
Daily Times (12/17/07)
Abstract (The New England Journal of Medicine, Volume 357:2451-2460, December 13, 2007, Number 24)