The First Face Transplant: The Face of Isabelle Dinoire

Abstract

Dear Editor, Since the 1990s, face transplants have received a great deal of press and public attention around the world. Isabelle Dinoire, the first woman who received a face transplant, became the center of attraction after undergoing an innovative surgical procedure. The first ethical approval for a face transplant in the world, was obtained by Agich and Siemionow’s team at the Cleveland Clinic in Ohio. The approach of Ohio scientists was based on more of a practical approach performed by a surgical team in Amiens, France.[1] Benoit Lengele, one of the surgeons involved, speculated a premeditated strategy, for the entire team to surreptitiously complete the process and contemplate each step thoroughly. Bernard Devauchelle was the pioneer in maxillofacial surgery. He and his team along with Jean-Michel Dubernard, a French pioneer transplant specialist have executed the first hand transplant on on November 27, 2005.[2] Unlike previous attempts, the French team submitted a case-by-case proposal for Dinoire rather than on behalf of hypothetical patients. Dinoire’s psychological and physical rehabilitation was aided by an interdisciplinary team based in Lyon and Amiens, and the procedure was not made public until after it had taken place. Because the procedure was leaked to a British newspaper, the face transplant became public much sooner than the team had planned.[3] After the continuous medical procedures, there was transmogrification in social, ethical, and clinical disagreements. After the initial facial transplant, the pool of thoughts drifted to immediate postoperative care rather than the indications of the surgery. Dinoire was apparently asymptomatic in the postoperative period and was completely fit both immunologically and functionally. She was able to perform all her duties within 12 weeks of the posttransplant period.[4] After 5 years of surgical innovation, Dinoire encountered that she was not able to eat, drink, or talk normally, but in subsequent publications around the same time, the surgeons emphasized the psychological and social benefits of undergoing a transplant over the functional issues Dinoire faced with a passing mention of her new life by virtue of her new face. The surgeons mainly focused on cosmetic outcomes. Functional and immunological outcomes were not emphasized despite the fact that she had previously been treated for two episodes of acute rejection. She also had renal failure and cervical cancer which could have stemmed from immunosuppressive medication. Dinoire died of lung cancer on April 1, 2016, at the age of 49.[5] Apprehending the importance of additional facial transplants, The Royal College of Surgeons delineated exigencies for successful facial transplants. Nonetheless, Peter Butler on October 25, 2006, the day before the publication of exigencies received ethical clearance from Royal Hospital, London, for performing four facial transplants. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.