A hospital in Spain says it has carried out the world's first full-face transplant, giving a man a new nose, skin, jaws, cheekbones, teeth and other features after he lost his face in an accident.
Other transplant experts lauded the surgery but were not sure it could technically be called 'full-face.'
The operation was carried out by a 30-member medical team in late March and took 24 hours to perform, according to the Vall d'Hebron Hospital in Barcelona.
The patient now has a completely new face from his hairline down and only one visible scar, which looks like a wrinkle running across his neck, said Dr. Joan Pere Barret, the surgeon who led the team.
"If you look him in the face, you see a normal person, like anyone else we have as a patient in the hospital," Barret told The Associated Press on Friday.
Barret declined to name the patient or give details of the accident five years ago in which the man lost most of his face, saying only that he was a Spaniard between 20 and 40 years old and was recovering well. The man cannot yet speak, eat or smile, but can see and swallow saliva, the surgeon said.
Prior to the latest surgery, the patient had undergone surgery nine times and could only breathe and be fed through tubes. He also had problems speaking.
In Britain, the UK Facial Transplantation Research Team called the Spanish operation "the most complex face transplantation operation there has probably been in the world to date." It stopped short, however, of calling it the world's first full-face transplant.
Barret said the operation involved removing what was left of the man's face and giving him a replacement "in one piece."
"It is a little bit like the movie with John Travolta and Nicolas Cage," he said, referring to the 1997 thriller "Face/Off", in which Travolta undergoes a high-tech medical procedure to acquire the villain Cage's appearance and infiltrate his terrorist gang.
"He is coming along well. He sits up, he walks in his hospital room and he watches television," Barret said.
Barret said there have been 10 partial-face transplant operations carried out in the world so far but this was the first involving a person's whole face. The world's first partial-face transplant was done on a woman in France in 2005. Other partial-face operations have been performed in the United States and China, as well as in other Spanish hospitals in Valencia and Seville.
The Spanish operation is similar to a near-total face transplant carried out in 2008 in Cleveland, Ohio, on a woman who was shot in the face.
But the Spanish case "seems to us to be more complex," said Neil Huband, a spokesman for the British transplant research team, based at the Royal Free Hospital in London.
He said the patient in Spain had also been shot in the face.
Dr. Maria Siemionow, who operated on the woman in Ohio, said the Spanish team had done great work. But a diagram she says she has seen about the Spanish surgery does not make clear that the team replaced the man's whole face, leaving doubts about his eyelids and jaw, she told the AP.
"It would probably be much more safer for the Barcelona team to say near-total," Siemionow said.
Barret said his team used the same plastic and microsurgery techniques as in those previous cases but decided to try a full-face transplant because the damage suffered by the man was so severe.
A week after the operation, the patient asked to look at himself in the mirror and was satisfied with what he saw, Barret said.
The patient had undergone psychiatric tests before the operation to determine if he would be able to confront having a totally new face, the hospital said.
He is expected to remain hospitalized for two months.