Health

 Updated at: 1302 PST,  Sunday, April 25, 2010
 WASHINGTON: A man who underwent the world’s first full facial transplant has had his first shave in five years, the surgeon who operated on him said.

Dr Joan Pere Barret said the patient, who is in his 30s, received a new beard from a donor as part of his new face.

In an operation at Barcelona’s Vall d’Hebron University Hospital lasting 24 hours, the patient now has a new nose, lips, tear ducts, cheekbones and jaw.

Dr Barret said the procedure had been a success and if all went well, the man could be back at work in five months after living for half a decade as a recluse.

The patient, who is believed to be a farmer who got shot in the face by an accident, has not spoken or eaten a proper meal for the last five years.

Dr Barret, 42, told The Daily Telegraph: "Many people with facial disfigurement feel very isolated, as in this case.

"He only went out when no one could see him, when there were not that many people around.

"His contact with the outside world was television and mass media, and his family.

"Now he wants to get his life back, he has plans for the future – he wants to work and have a normal life.

"I am sure he is looking forward to going to a bar and having a beer."

Dr Barret said the team of 14 consultants at the hospital worked three at a time in three hour shifts on the patient from 9pm on March 20 to 9pm the following day.

They were supported by 10 junior resident doctors.

"We had the radio on, we were chatting - it was very relaxed," he said. "At some points it felt like we had taken a weekend holiday – everyone was so excited."

Three days after the operation, the doctors had to tackle the unusual problem of the patient’s growing beard.

"We have had to shave him every three or four days. We do not use a Gilette razor in case of infection, so he has a little stubble – he looks very handsome."

The hospital only released details of the procedure on Thursday after the patient had been out of danger for a month.

Dr Barret said the man’s family were very emotional when they saw his face and started to recognise the person he was before his accident.

A week after the operation, the patient asked for a mirror to study his own reflection.

"He asked to see his face on day seven after the surgery, he is a very strong man," said Dr Barret.

"He was very calm, he wrote down on a piece of paper that he was satisfied with the operation. He was very happy, he gave the impression that he was at peace.

"It was as though everything he has been through was over, all these five years of pain were over – he was back."

The operation was publicly funded and there were four patients who were considered suitable for transplants and agreed to the risks.

Doctors had to make sure that the donor had the same skin tone and was the same weight, height and age as the patient.

After securing permission from the donor family, surgeons were able to proceed.

Under Spanish law, neither the donor family nor the patient can be identified to the other, even if they wanted to.

Dr Barret, who worked in Britain for three years, said: "They would not be allowed to know.

"The face has been completely changed, there is no resemblance at all to the donor at all. We have seen the donor and we have seen the results."

There is now the possibility that a similar procedure could take place in Britain within months.

Dr Barret said he was working at the St Andrew plastic surgery centre in Chelmsford in Essex in 2004 when the decision was made that not enough was known about the procedure at that time.

"I know that Britain is waiting to do a facial transplant," he said. "I am sure it will happen soon."

The British face transplant team have been ready to perform an operation for some months after gaining ethical approval in 2006 and preparing several candidates.

The team based at the Royal Free Hospital in Hampstead, north London, have approval to carry out four face transplants on burns patients.

Their protocol does not involve taking muscle or bone as the Spanish team have done but is likely to involve transplanting a complete face.

Prof Peter Butler who heads the team, said: "We congratulate Dr Barret and his transplantation team in Spain on what may well be the most complex facial transplantation operation carried out so far worldwide. Secondly I would like to wish the patient well for the future.

"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.

"This operation once again shows how facial transplantation can help a particular group of the most severely facially injured people, for whom reconstructive surgery has not worked and for whom the quality of life is indescribably poor. These are people who live a terrible twilight life, mostly shut away and hiding from public gaze."

Dr Barret, head of the department of plastic surgery and burns at Vall d'Hebron, said the man wanted his first real meal to be lamb.

"He should be able to eat next week, but he will probably have to start with softer foods - not the meal he really wants. He can't eat lamb at the moment."