About 100 medical workers participated in the operation, and the intervention lasted more than 15 hours. The doctors managed to avoid complications — the tissues are integrating, and the patient is recovering successfully.
At the Vall d'Hebron hospital in Spain, a world-first operation was performed in which doctors transplanted part of a face from a donor who voluntarily chose to end their life. Euthanasia has been legalized in the country since 2021, and anyone can bequeath their body to science. The donor personally offered to transplant part of their face to the recipient. There have been no known cases like this before.
The new face was received by a woman named Carme. She required surgery after a bacterial infection caused by an insect bite. Doctors diagnosed her with soft tissue necrosis, and the woman was unable to speak, eat, drink, or see properly.
"Face transplantation is performed in cases where a person is missing parts of their face that cannot be restored using standard methods. Patients are people with severe burns, injuries, or congenital defects that affect essential life functions," says Dr. Joan-Pere Barret-i-Nerin, head of the plastic surgery and burn treatment department at Vall d'Hebron University Hospital.
Carme after the operation (third from the left) with the medical team. Source: Vall d'Hebron.
Official press conference. Source: Vall d'Hebron.
The preparation for the operation was meticulously planned, with medical professionals considering every detail. A tissue transplant from the central part of the face was necessary. Approximately 100 specialists were required for the procedure, including psychiatrists and immunologists.
For a successful face transplant, it was essential that the donor and recipient were:
- of the same gender,
- had the same blood type,
- had a similar head size.
Additionally, psychotherapists also worked with the recipient. It was important for the doctors to understand that the person was aware of the seriousness of the operation, ready for recovery, potential complications, and acknowledged that they would have to live with someone else's face.
It was at Vall d'Hebron hospital in 2010 that the first full face transplant in the world was performed. This time, the medical institution was also a pioneer, as it was the first time a donor was someone who chose euthanasia.
Using 3D technology, the medical team modeled a three-dimensional model of the faces of the donor and recipient. Experts also developed a silicone mask that could be used as a stencil.
At least half a day was required for the large team of specialists to transplant skin, fatty tissue, peripheral nerves, facial muscles, and facial bones. After the operation, the woman spent a month in the intensive care unit for burn patients, followed by time in the trauma, rehabilitation, and burn treatment department.
During this time, the medical professionals monitored the tissue integration and taught the woman to chew, swallow, and speak again.
"Initially, the patient's face is in a hypotonic state and does not move because the nerve connections have not yet formed. We work with the face to stimulate innervation, using tools such as mirrors, various textures, and images of the patient so they can recall the movements and visual perception of their face," explains Dr. Daniela Issa from the department of physical medicine and rehabilitation.
The doctors successfully completed the entire treatment plan, and the recovery went well. Carme has now been discharged from the hospital; she can speak, chew, and see the world. The woman admits that she is very grateful to her donor, as making such a decision is true altruism that cannot be left without respect.
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