Farmer's gunshot-ruined face rebuilt at Vall d'Hebron Hospital

A young farmer who suffered a gunshot wound to the face has received the world's first full facial transplant at a hospital in Spain.

The 24-hour operation, carried out by a 30-member surgical team at Vall d'Hebron Hospital in Barcelona, marks the first time an entire face — including the skin, muscles, teeth, lips, cheekbones and jaw — has been transplanted and reconstructed, using tissue from a brain-dead donor, the Times of London reported.

The transplant recipient, identified only as a man in his 30s, lost his nose, jaw, and other parts of his face when he accidentally shot himself in 2005. He was left with nothing but a hole between his mouth and where his nose should have been, and had been unable to eat, speak or breathe normally for the last five years.

The surgery was carried out March 30.

Dr. Joan Pere Barret, the lead surgeon, said that the procedure was a complete success and that the patient was recovering well in the hospital with no sign of tissue rejection or infection.

"It is a full-face transplant, restoring all the bones and no grafts," Barret told the Times of London. "He has the face of a complete new human being. Relatives say that he looks in some areas like he did before the accident, but he doesn't look like the donor at all. He's changed completely."

Barret said the man asked to see his face seven days after the surgery.

"He was very pleased and satisfied," the surgeon said. "From our point of view, he looks fantastic. He is the best facial transplant ever."

The procedure involved removing the entire facial skin and muscles, nose, lips, palate, teeth, cheekbones and the jawbone from the donor while preserving the blood supply.

The patient's arteries and veins were then isolated and the donor's face checked to ensure that there was a complete flow of blood.

Then bones, nerves and muscles were transplanted and connected to his own blood vessels, nerves and skin. Metal plates were used to support the structure of the new face, which included reconstructing the roof of the mouth.

The patient is able to walk and sits in a chair to watch TV. He is expected to start "talking and eating, and also smiling and laughing" within a few weeks' time, Barret said. "He couldn't talk at all before the surgery, but our plan is that with steroids and other drugs we are considering to allow him to start swallowing next week."

The patient underwent psychiatric tests before the operation to determine if he would be able to confront having a totally new face, the hospital said.

He is likely to remain in hospital for at least two months and will be closely monitored for four months after that. But he should eventually be left with a normal appearance, without scars or distortions in the skin.

Before the transplant, the young man had been operated on nine times, but still had severe difficulty breathing, swallowing and speaking. He had to breathe and be fed through tubes, the hospital said.

Although at least 10 facial transplants have been performed in France, the U.S., China and Spain, all have involved only part of the face. This is said to be the first time a full-face procedure has been carried out.

With News Wire Services

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