Last December 2008, a plastic surgeon named Maria Siemionow, after several years of extensive research on mice and cadavers, succeeded in transplanting more than 80 square inches of skin, with muscles, bone, upper lip and nose still attached from an anonymous donor on a young woman who, after what the doctor said, "did not have a midface" after she underwent traumatic injury.
After two months the patient has returned to her basic functions like the sense of smell and the ability to drink from a cup. She has been discharged from the hospital and appears to be recovering.

Heart, liver, kidney and even lung transplants have become common surgical procedures, but transplants of pieces of the body that contain many types of cells — skin, muscle and bone, for example — are much more difficult. The first hand transplant occurred in 1999. French scientists carried out the first partial face transplant in 2005. The new procedure, however, is far more involved: Siemionow transplanted 80 percent of the woman's face from the donor.

Siemionow emphasized that the full facial transplant is a last resort for a "very specific" type of patient. Patients who need an entirely new face have limited options. They can have skin grafted onto their faces from their own bodies, but the skin from the thighs, arms, abdomen and other common sources look slightly different, producing the unsightly quilt-like effect that is familiar from burn-victim photographs. To avoid that problem, Siemionow looked into using one contiguous piece of skin from some other area on the body, but their research showed that no area of the patient's own body contains the necessary 100 square inches of skin necessary to cover the whole face. For a full facial skin transplant, there's no alternative to using a donor, Siemionow stated.

Ethical questions have been raised about the procedures. While the transplant appears to have improved the first patient's quality of life, the immunosuppressants that the patients have to take for the rest of their lives could be unsafe. "One case is merely an anecdote. It doesn't create a scientific basis to say it's safe for a patient to do this," Carson Strong, a professor of human values and ethics at the University of Tennessee College of Medicine, told the Washington Post last December.

Erica Villa