The Ultimate Transplant; Surgeons are ready to offer burn victims entire faces from donors, but there are risks.

Byline: Karen Springen

For thousands of people whose faces have been disfigured by third-degree burns or other injury, life often becomes an endless series of painful operations. Surgery is performed to transfer skin to the face from the back, buttocks, thighs or even scalp; to improve breathing; to enable patients to open and close their eyes; to restore facial expression. A few patients have had as many as 120 operations. "It's a roller coaster. You're healing well, and then you have to go in for another surgery," says Amy Acton, executive director of the Phoenix Society for Burn Survivors.

Now burn victims can consider another option: a face transplant. Two weeks ago French doctors performed the first partial procedure when they gave a brain-dead patient's mouth, nose and chin to a 38-year-old woman mauled by a dog. Doctors at the Cleveland Clinic in Ohio, whose institutional review board last year approved the experimental treatment, are interviewing potential patients who would receive entire faces from donors. "At this stage, we are planning face transplants only for severely disfigured patients who have exhausted all conventional options," says Maria Siemionow, director of plastic-surgery research.

The goal is to help burn victims look normal and function as well as possible by giving them a just-deceased person's facial tissue. Patients will receive skin (but not the underlying muscle and bone) from someone their own age, gender and race. "If we took the bony structure and the soft tissue, then they would look like the donor," says John Barker, director of plastic-surgery research at the University of Louisville in Kentucky. Unlike skin from other parts of the body, facial tissue is uniquely thin and pliable, which makes it easier to stretch around the eyeballs and mouth. As a result, face-transplant recipients shouldn't need to undergo so many operations to try to ...