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Partial face transplant patient speaks about her experience

Tuesday, February 7, 2006

AMIENS, France -- She spoke resolutely and with pride about her newly transplanted features, although she struggled to pronounce her b's and p's. She drank from a plastic cup -- showing that the mouth that once belonged to someone else works just fine.

Most of all, Isabelle Dinoire demonstrated remarkable poise as she endured a battery of questions at her first news conference since she became the world's first face transplant recipient.

Dinoire's new face is still largely immobile, and it was hard to tell whether the 38-year-old mother of two was nervous. She smiled more with her eyes than with her lips, which still do not seem to move much, other than slightly up and down.

After a while, she appeared to warm to the attention. When Dinoire took a sip of water, the simple gesture sparked a flurry of photographs, and she seemed to hold the pose for a moment.

"I can open my mouth and eat. I feel my lips, my nose and my mouth" -- and she said she still can smoke.

Dinoire has only a faint scar around her nose, mouth and chin where surgeons stitched on a mask of tissue from the donor in a 15-hour surgery in Amiens on Nov. 27, repairing a gaping hole from a dog mauling.

Up close, it looks as though someone placed an oval-shaped anti-dust mask around her nose and mouth and traced a pencil line. A few feet away, the scar is invisible.

Before, Dinoire's lipless gums and teeth were permanently exposed, and most of her nose was missing. She wore a surgical mask in public to avoid frightening people.

"Since the day of my operation, I have a face like everyone else," Dinoire said. She thanked the family of the donor, whose heart, liver, pancreas and kidneys were distributed to other patients.

She said she was eager to return home and find a job.

"I want to have a normal life again," she said.

Dinoire spoke frankly about the attack in May by her pet Labrador, which left her disfigured. She said she was wrestling with personal problems, had had a trying week, and "took some drugs to forget," which knocked her out.

"When I woke up, I tried to light a cigarette, and I didn't understand why I couldn't hold it between my lips," she said. "That's when I saw the pool of blood and the dog next to me.."

She also explained the difficulties of life with disfigurement, saying she drew stares when she went out. "I understand all people who have a handicap," she said.

Dinoire's doctors said they have asked French health authorities for permission for five more similar transplants. Dr. Jean-Michel Dubernard said they wanted "to give this operation to many other people in France and in the world."

In terms of coloring, the match between Dinoire's own skin and the graft was remarkable, though she also wore makeup. Her doctors said that, with time, her ability to pronounce letters like "b" and "p" will improve.

Doctors showed slides of her progress, her scar growing fainter each week. Though the donor's nose had been bruised during efforts to revive her, the mark quickly healed after the tissue was transplanted, a sign the graft was successful.

Dinoire said she "accepted immediately" when her surgeons suggested the transplant. But the procedure has been unable to restore the way she once looked.

"There's no comparison between the face I have today and the face I had seven months ago, it is totally different," she said.

Her surgeons -- who have been criticized for going ahead with a radical, untested procedure without trying traditional reconstruction first -- defended their decision and said they repeatedly warned Dinoire about the risks.

Dubernard said he hopes that Dinoire will break her smoking habit, as it can lead to complications. "In hiding, she smokes cigarette after cigarette," he said.

But he also showed understanding. "Put yourself in her place for a second," he said. "It's extraordinarily stressful."

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