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ianstone
07-26-2010, 12:14 PM
Full-face transplant patient tells of his joy as he appears in public for the first time after ground-breaking surgery



By Daily Mail Reporter (http://www.dailymail.co.uk/home/search.html?s=y&authornamef=Daily+Mail+Reporter)

Last updated at 4:58 PM on 26th July 2010

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Spanish farmer was left horribly disfigured following hunting accident
Oscar's new face doesn't look like donor, who will not be named
Patient will regain 90% of facial functions after physical therapy


http://i.dailymail.co.uk/i/pix/2010/07/26/article-1297747-0A935C67000005DC-876_306x459.jpg Oscar, 31, underwent a full-face transplant in March. He appeared in public today for the first time at a news conference at the Vall d'Hebron Hospital in Barcelona, Spain

A Spanish farmer who had the world's first full-face transplant has appeared in public for the first time since his pioneering surgery.
Identified only as Oscar, the 31-year-old spoke with considerable difficulty at a news conference as he thanked the medical team that gave him a new face in late March at a Barcelona hospital, as well as the family of the donor.
Vall d'Hebron hospital said that Oscar will need between a year and 18 months of physical therapy and expects him to regain up to 90 per cent of his facial functions.
The patient was horribly disfigured in a shooting accident five years ago, leaving him unable to breathe or eat on his own.

Addressing reporters this morning, Oscar said: 'I'm very happy to be here and I wanted to express my gratitude to the hospital and medical team and to all donors in Spain, especially the family of the man whose face I received.'
Doctors said the new face does not resemble that of the donor, whose identity has not been revealed.
Oscar's sister, who was not named at the conference, said: 'We are very happy and content and very grateful to the hospital because now he can start his new life.

'He is looking forward to doing the normal little things in life again, the things we do every day without having any problems.

'Things like walking down the street without people looking at him five times.

'He's looking forward to sitting down with his family and having a family meal. He's very comfortable with his face, he feels very good.
'He used to love hunting and fishing and he wants to hunt and fish again."
Oscar, whose surname was not revealed to protect his privacy, had blown most of his face off with a gun in the hunting accident. He was left unable to breathe, swallow or talk properly.
Nine earlier surgical attempts to rebuild his face had failed.

Then in March this year, he made medical history when he became the first person in the world to undergo a full facial transplant.

http://i.dailymail.co.uk/i/pix/2010/07/26/article-1297747-0A936FCB000005DC-260_634x389.jpg Oscar (centre) with his sister and Dr Joan Barrett at the press conference. He can now eat a soft food diet and is learning to speak again

During surgery on March 20, 2010, the patient received a transplant of all the skin and muscles of the face, nose, lips, upper jaw, all teeth, palate, cheekbones and jaw, as well as the lacrimal system.


The 24-hour operation involved 30 surgeons, anaesthetists, nurses and other medical experts at the Vall d’Hebron hospital in Barcelona. The complicated procedure included plastic surgery and microsurgery to repair blood vessels.

Oscar can now move his eyebrows and upper eyelids, although he is still unable to close his eyes. He can also move his jaw and his cheek muscles. He has been on a soft food diet for one month and is able to drink liquids. He started to speak two months ago.
Oscar is having speech therapy, physiotherapy and facial therapy to help him recover full movement in his facial muscle

In a statement, the transplant team said they expected him to recover full movement during the next 12 to 18 months.

http://i.dailymail.co.uk/i/pix/2010/07/26/article-1297747-0A936C42000005DC-630_634x410.jpg Oscar stands beside Dr Joan Barret, left, and is surrounded by his doctors. He was treated by a team of 30 specialists

However, the treatment has not gone entirely smoothly. Oscar has suffered two acute rejections of his new face since the surgery, one after four weeks and the other between the second and third month.

Despite these problems his medical team say Oscar is psychologically robust enough to return home.

In a statement, the medical team said: 'He has readily accepted his face with no difficulty and a few days after the operation he was already able to see his reflection and recognise himself.'
Dr Joan Barret, head of the hospital's plastic surgery and burns department, said: 'It was a very brave thing to face everyone today because he is a quiet man who wants to live a normal life.

'He has been very isolated and wants to do what all young men want to do. He is single, he wants to go out with his friends and have fun.'

Enlarge http://i.dailymail.co.uk/i/pix/2010/04/23/article-1268104-09420C2C000005DC-944_634x432.jpg (http://i.dailymail.co.uk/i/pix/2010/04/23/article-1268104-09420C2C000005DC-944_634x432_popup.jpg)

Dr Barret said his team is currently evaluating other cases similar to Oscar to see if they could conduct a similar surgery.
There have been 11 partial face transplants carried out since Isabelle Dinoire had her face repaired by French surgeons in 2005. Five have been performed in France, two in Spain and two in the U.S, one in Egypt and one in China.

There have also been two full face transplants, Oscar and a man known as Jerome in France. None have been performed in the UK.

http://i.dailymail.co.uk/i/pix/2010/07/26/article-1297747-0A9371C9000005DC-667_196x273.jpg Before the operation: Oscar lost his nose in a hunting accident

Dr Barret, the hospital’s head of plastic surgery, said: ‘The patient has scars on his forehead and his neck but they will become invisible in the future.

‘He saw himself when he told us he wanted to and psychologists said he was ready. It was a week after the operation and he reacted well, saying he was satisfied with the result.’

Although Oscar has been given someone else’s face, he has not taken on the looks of the donor, who died in a road crash.

Instead, his new face is a hybrid, identical to neither his old one nor the donor’s but reminiscent of both.
The biggest concern now is that Oscar's body may reject the transplant. He will have to take powerful immunosuppressant drugs for the rest of his life and faces an increased risk of cancer as a result. The drugs can also trigger other illnesses such as diabetes.

Miss Dinoire’s body tried twice to reject the transplant and a Frenchman who was given a new face in two stages died after an infection triggered a heart attack.



There are also fears that patients who have already gone through the trauma of a major accident, plus countless operations, will struggle to cope psychologically with the effects of losing their identity.
However, many believe the risks are worth taking.
http://i.dailymail.co.uk/i/pix/2010/04/23/article-1268104-09471547000005DC-388_634x358.jpg
Medical history: Dr Joan Pere Barret with X-rays showing the shattered face of the man prior to the operation
British surgeon Peter Butler, who had hoped to carry out the world’s first total face transplant at London’s Royal Free Hospital, believes the technique could one day benefit millions.
http://i.dailymail.co.uk/i/pix/2010/07/26/article-1297747-05CB16A50000044D-855_306x373.jpg Isabelle Dinoire, pictured in 2006 almost one year after she received the world's first partial face transplant

Mr Butler has said: ‘There are a quarter of a million people in the UK with severe facial disfigurement for whom reconstructive surgery has not worked.
‘Their quality of life is indescribably poor and many seldom leave their homes.
‘They live an almost twilight existence, hiding in shadows and afraid to expose themselves to unforgiving public scrutiny.
‘Nobody underestimates the challenges of what we propose to do, but if facial transplantation is successful, it will be the first option offered to those who live in that awful twilight zone, and not the last.
‘It will give them the opportunity to once again walk along a street in broad daylight with nobody noticing.’
Congratulating the Spanish team, Mr Butler said: ‘We must also remember the family of the donor who, we understand, has helped not only the facial transplantation patient but others, with various forms of organ donation.
‘To help others, not only to live but to have a good life, is a supreme act of human generosity.’



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