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Gunner 0313
12-17-08, 11:45 PM
First-ever face transplant in U.S. successfully completed

BY CORKY SIEMASZKO
DAILY NEWS STAFF WRITER
Updated Wednesday, December 17th 2008, 1:58 PM
http://assets.nydailynews.com/img/2008/12/18/alg_face_transplant.jpg Dr. Risal Djohan, Dr. Maria Siemionow and Dr. Daniel Alam (l.-r.) of the Cleveland Clinic perform a near-total face transplant, the first of its kind in the nation.

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A horribly disfigured woman who lived like an outcast because of her appearance woke up Wednesday with a brand new face.

The Cleveland Clinic (http://www.nydailynews.com/topics/The+Cleveland+Clinic) announced it has performed the first ever face transplant operation in the U.S. (http://www.nydailynews.com/topics/United+States) - and the most radical makeover of its kind ever.

Doctors replaced all but the woman's chin, lower lip, upper eyelids and forehead. The other 80% of her face was replaced with one donated from a female cadaver.

They also grafted on facial nerves and muscles so the woman's new face functions - and is not just a mask.

"Our patient was called names and humiliated," said Dr. Maria Siemionow (http://www.nydailynews.com/topics/Maria+Siemionow), who led that team that performed the 22-hour operation two weeks ago. "You need the face to face the world."

Siemionow did not identify her patient and said even less about the female donor beyond saying that she "deserves our thanks."

Before the operation, the transplant patient - whose face was ruined by some kind of traumatic accident - could not smile or smell or taste. Now, she can, doctors said.

"We never thought for a moment that our sister would ever have a chance at a normal life again, after the trauma she endured," the woman's sibling said in a statement. "There are tears of joy, and tears of pain that it took one to pass for one to have the life."

Dr. Warren Breidenbach (http://www.nydailynews.com/topics/Warren+Breidenbach), a surgeon at Jewish Hospital in Louisville (http://www.nydailynews.com/topics/Louisville), Ky., who did the nation's first hand transplant in 1999, said the woman with the new face was in good hands. "She's a leader in this field," Breidenbach said of Siemionow, a graduate of the Poznan Medical Academy (http://www.nydailynews.com/topics/Poznan+Medical+Academy) in Poland (http://www.nydailynews.com/topics/Poland).

It is only the fourth face transplant ever.

The first was performed in France (http://www.nydailynews.com/topics/France) three years ago on Isabelle Dinoire (http://www.nydailynews.com/topics/Isabelle+Dinoire), a 38-year-old woman who had been mauled by her dog. Dinoire received a new chin, lips and nose from a brain-dead donor and made a remarkable recovery. That ground-breaking surgery set off an ethical debate that continues to this day.

Another face transplant was subsequently performed on a French man disfigured by a genetic condition. A third such operation was reported on a Chinese farmer who had been attacked by a bear.

"This is very good news for all of us," said Dr. Laurent Lantieri (http://www.nydailynews.com/topics/Laurent+Lantieri), a French plastic surgeon who did the second face transplant operation. The Cleveland (http://www.nydailynews.com/topics/Cleveland) patient is healing rapidly. Transplant recipients run the risk their bodies will reject their new faces, so they are sentenced to a lifetime of taking immune-suppressing drugs.

A nasty side effect of these drugs is that it raises the odds of a patient coming down with cancer and other diseases.

Bioethicist Arthur Caplan (http://www.nydailynews.com/topics/Arthur+Caplan) said this is why face transplant patients need to know that assisted suicide is an option if the operation doesn't take.

"If your face rejects, it would be a living hell," said Caplan, of the University of Pennsylvania (http://www.nydailynews.com/topics/University+of+Pennsylvania).