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Last Updated: Thursday, 15 December 2005, 19:56 GMT
UK full face transplant search on
Face ops
French surgeons operate on the first face transplant patient
UK experts have been granted permission to identify a patient for the world's first full face transplant.

Consultant plastic surgeon Dr Peter Butler has been given the go-ahead by a hospital ethics committee to find a patient who meets selection criteria.

But further ethical approval would be needed to then perform an operation.

The approval, given to Dr Butler and his team at north London's Royal Free Hospital, follows the world's first partial face transplant in France.

Medics in Amiens, northern France, replace the nose, lips and chin of Isabelle Dinoire, 38, who had her face mauled by her dog.

Identifying the right patient is the key to the procedure and is definitely the hardest part, rather than the actual operation
Dr Peter Butler

Dr Butler, who has been researching the process for 10 years, said the selected patient was likely to have severe facial burns or facial trauma and to have already had skin grafts.

"Quite a lot of issues around patient selection are not only physical but psychological," he said.

Choosing the right patient was "the most significant part of the process", he added.

"Identifying the right patient is the key to the procedure and is definitely the hardest part, rather than the actual operation."

He said one of the biggest obstacles he faced was the concern by donor groups that the donor's face would be easily recognisable on the person who received it.

Computer simulations had proved that donor families would not recognise the face on a recipient, Dr Butler added.

'Further work'

Resistance to the selection process could come from the Royal College of Surgeons who said in 2003 that further work was needed and that it was "unwise" to proceed.

"That further work has now taken place and we have now gone as far as we can go with research and the next step is to do the process," Dr Butler said.

We are determined to do this the way we think is right
Royal Free Hospital

The team says it is hopeful a suitable patient can be found so that it can again apply to the hospital ethics committee, this time for permission to perform an operation.

Royal Free Hospital chief executive Andrew Way said Dr Butler and his team were making "steady progress" in identifying a suitable patient.

"The team has been working on an assessment tool for patients seeking face transplants and has now been given permission to identify patients using this tool," he said.

"We are determined to do this the way we think is right and will not be rushed into anything because of what teams in other countries are doing."

Last week, Dr Butler said patients with facial injuries could not now be denied transplants.

Speaking in the British Medical Journal, he said that, in light of the success of the French transplant, concerns over drugs and psychological impact could be hard to justify.

Watch a surgeon talking about the surgery

Woman has first face transplant
30 Nov 05 |  Health
Q&A: First face transplant
30 Nov 05 |  Health

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