A year and a half after the first facial transplant - an operation that brought to mind elements of Hollywood thrillers like Silence of the Lambs and Face/Off - the recipient is showing progress according to a study in The New England Journal of Medicine.
Isabelle Dinoire, a French woman and mother of two who was injured by her pet Labrador, received a new nose, chin, cheeks and lips in 2005. Since that time, only two similar operations have been performed - one in China and another in France.
Despite the good news, the complex facial surgery has not resulted in a complete, "good-as-new" recovery. Twice her body has tried to reject the transplant, though both times this was successfully suppressed. Scars remain, and she continues to take powerful medications - strong enough that they initially twice caused her kidneys to fail and forced doctors to change her prescriptions.
However, makeup can now conceal the scars from what would normally be a horribly disfiguring accident. Without the transplant, food dripped from her mouth and she wore a surgical mask in public to hide the damage.
Within a week, Dinoire was able to eat and drink almost normally - sometimes drinks leaked from her mouth at first, though this stopped completely within a year.
It was three months before Dinoire was able to return to the outside world, returning to her social life slowly. At this time, she had yet to regain the motor function or even the ability to feel through her new skin. This would come later and gradually.
At four months, she was able to feel hot and cold sensations almost normally in parts of her new face; at six months it was completely normal across the entire face. She could again feel light touches.
Motor skills took longer. At first, she performed facial exercises twice a day for four months; primarily focused on moving her mouth and lips. After about 12 weeks, she was able to move her upper lip. Soon after she was able to pronounce "p" and "b" sounds and physical therapy was reduced to once a day.
This has progressed quickly considering the trauma and complexity of the surgery. This month, she is now able to show emotional expressions in her face ad doctors pronounced her motor skills as having returned to normal.
The face graft was performed on Nov. 27, 2005, in Amiens, France. The donor was a 46-year-old woman whose brain no longer functioned.
The New England Journal of Medicine study is authored by a group of 27 physicians who participated in the surgery and treatment.