Face of the future

The world’s first full facial transplant could finally happen in the United Kingdom this year. Peter Butler, leader of the surgical team at the Royal Free Hospital in north London preparing to carry out the controversial procedure, is uncharacteristically hesitant about details. One reason is his heightened sensitivity about the British media. The press have been on red alert over Butler’s activities ever since a French team performed the first partial facial transplant in November 2005. About 31 patients have approached Butler’s team seeking a facial transplantation. The details of some of them were leaked to the press, leading to interviews with patients’ families. Journalists will be especially keen to uncover the identity of whoever becomes the first eventual donor, Butler believes.

Butler has been working on how to do a facial transplant for 15 years. In fact, one of the lead surgeons on the French team credits him with the idea, but Butler’s fastidious working methods and the Royal College of Surgeon’s resistance meant he didn’t get to do the first transplant. French surgeons replaced the nose, chin, and mouth of Isabelle Dinoire in 2005 after she had been mauled by her dog. Since then, a further partial transplant has been done in France, and one in China. Butler’s team now has approval from the ethics board to conduct four full facial transplants. “The next phase will be to look for a donor face to match them. It’s a long process. It will probably be this year, but we are not sure. There are about four to five patients that are ideal but they don’t want to be the first.”

The burden …