Health Check: 'Instead of repairing old, saggy faces, why not replace them with fresh, young, taut ones?'

For cosmetic surgeons, it would represent the ultimate operation - a victory over the ageing process that would consign face-lifts, Botox injections and anti-wrinkle creams to history. Instead of repairing old, saggy faces, why not replace them with fresh, young, taut ones? The idea has the nightmare quality of science fiction. But in this case science fiction is becoming science fact - and surgeons could make a start tomorrow.

Some are already itching to give it a go. Teams in the US, Britain, France and Columbia are researching the technique of face transplantation and it is only a matter of time before someone attempts it. All that is restraining them is their research ethics committees and their own consciences. The first candidates for such radical surgery would be people disfigured by accident or disease. But the Royal College of Surgeons last week looked further ahead to the time when the treatment may have become established - even routine.

"Once a treatment exists," it said, "increasing numbers of people try to track it down. In the case of facial transplantation the example of the ageing rich seeking to look more youthful has been cited."

The college has gazed into its crystal ball - and seen a future peopled with Dorian Grays. But there is a long way to go before it comes to pass and the college tried to slow its arrival last week by publishing a report calling for a moratorium on the surgery until more research has been done.

It had been alarmed by the hype around the operation triggered a year ago when a British surgeon, Peter Butler, of the Royal Free Hospital, announced that face transplants were technically possible - easier than stitching back a finger, it was claimed last week - and he and his team were investigating them. Ten people contacted Mr Butler for more information, prompting a frantic scramble by the tabloid press to identify the first likely candidate for the groundbreaking surgery.

The royal college decided the best way to curb the stampede and inject some balance into the debate was to set up a working party to examine the issues. The launch of its report last week was a surprisingly gloomy affair, given the excitement that the operation has generated in plastic surgery circles. Sir Peter Morris, the president, insisted they were not averse to the idea of face transplants, merely cautious about the risks. But the overwhelming view of the group was that this was not an operation that could be justified in the light of current medical knowledge, nor likely to become so in the near future.

Most transplants of whole organs are life saving, so risks are acceptable because the alternative is death. But face transplants are about improving the quality, not the quantity of life and failure could be devastating. One horrendous scenario spelt out by the group was of a person who has a transplant of the skin, underlying tissue and muscle of the face. Should that fail and have to be removed, the recipient would be left, potentially, with nothing but a skull and a few muscles for chewing - literally, faceless.

The main barrier to success is rejection. Even assuming the transplant went well and the recipient became used to their new face, there would be the nagging worry that it might go wrong. The skin provokes the strongest immunological reaction when transplanted and it is estimated that in up to half of cases, thickening of the tissues and unsightly scarring could develop in two to three years. The key would be to induce "transplant tolerance" - a state in which the immunological reaction is overcome without the need for anti-rejection drugs. This is the Holy Grail of transplantation. Sir Peter Morris, the president of the Royal College of Surgeons, said last week he had spent his entire professional life working on it and while he wished for a breakthrough it was "not around the corner."

Despite these caveats, it is virtually certain that someone, somewhere will proceed with a face transplant in the not too distant future. The history of transplantation is of maverick surgeons challenging the prevailing orthodoxy until their radical procedures become mainstream. When Christiaan Barnard carried out the first heart transplant in 1967 in South Africa there were protests that he was interfering with men's souls. When the first hand transplant was carried out in 1998 there were warnings that the recipients would experience major psychological and rejection problems - and some have done so. But 20 hand transplants have been carried out to date and the operation is becoming a rare, but viable, option.

In face transplantation, these problems would be magnified. The face is central to our understanding of our own identity and disruption to it causes a profound disruption of our body image, as the college says. But if the rejection problems could be overcome, the gains for people disfigured by accident or disease could be very great. We should not let our revulsion at the idea of swapping faces deter those trying to make it happen.

Arts and Entertainment
Louis Theroux: By Reason of Insanity takes him behind the bars again
tvBy Reason of Insanity, TV review
Arts and Entertainment
Cassetteboy's latest video is called Emperor's New Clothes rap
videoThe political parody genius duo strike again with new video
Seth Rollins cashes in his Money in the Bank contract to win the WWE World Heavyweight Championship
WWERollins win the WWE World Heavyweight title in one of the greatest WrestleMania's ever seen
Arts and Entertainment
tvPoldark, TV review
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Sales Call Handler

    £14500 per annum: Recruitment Genius: An opportunity has arisen for a Sales Ca...

    Recruitment Genius: Support Worker

    £14560 - £15000 per annum: Recruitment Genius: This company offers unique pers...

    Recruitment Genius: Junior Web Designer - Client Liaison

    £6 per hour: Recruitment Genius: This is an exciting opportunity to join a gro...

    Recruitment Genius: Service Delivery Manager

    Negotiable: Recruitment Genius: A Service Delivery Manager is required to join...

    Day In a Page

    No postcode? No vote

    Floating voters

    How living on a houseboat meant I didn't officially 'exist'
    Louis Theroux's affable Englishman routine begins to wear thin

    By Reason of Insanity

    Louis Theroux's affable Englishman routine begins to wear thin
    Power dressing is back – but no shoulderpads!

    Power dressing is back

    But banish all thoughts of Eighties shoulderpads
    Spanish stone-age cave paintings 'under threat' after being re-opened to the public

    Spanish stone-age cave paintings in Altamira 'under threat'

    Caves were re-opened to the public
    'I was the bookies’ favourite to be first to leave the Cabinet'

    Vince Cable interview

    'I was the bookies’ favourite to be first to leave the Cabinet'
    Election 2015: How many of the Government's coalition agreement promises have been kept?

    Promises, promises

    But how many coalition agreement pledges have been kept?
    The Gaza fisherman who built his own reef - and was shot dead there by an Israeli gunboat

    The death of a Gaza fisherman

    He built his own reef, and was fatally shot there by an Israeli gunboat
    Saudi Arabia's airstrikes in Yemen are fuelling the Gulf's fire

    Saudi airstrikes are fuelling the Gulf's fire

    Arab intervention in Yemen risks entrenching Sunni-Shia divide and handing a victory to Isis, says Patrick Cockburn
    Zayn Malik's departure from One Direction shows the perils of fame in the age of social media

    The only direction Zayn could go

    We wince at the anguish of One Direction's fans, but Malik's departure shows the perils of fame in the age of social media
    Young Magician of the Year 2015: Meet the schoolgirl from Newcastle who has her heart set on being the competition's first female winner

    Spells like teen spirit

    A 16-year-old from Newcastle has set her heart on being the first female to win Young Magician of the Year. Jonathan Owen meets her
    Jonathan Anderson: If fashion is a cycle, this young man knows just how to ride it

    If fashion is a cycle, this young man knows just how to ride it

    British designer Jonathan Anderson is putting his stamp on venerable house Loewe
    Number plates scheme could provide a licence to offend in the land of the free

    Licence to offend in the land of the free

    Cash-strapped states have hit on a way of making money out of drivers that may be in collision with the First Amendment, says Rupert Cornwell
    From farm to fork: Meet the Cornish fishermen, vegetable-growers and butchers causing a stir in London's top restaurants

    From farm to fork in Cornwall

    One man is bringing together Cornwall's most accomplished growers, fishermen and butchers with London's best chefs to put the finest, freshest produce on the plates of some of the country’s best restaurants
    Robert Parker interview: The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes

    Robert Parker interview

    The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes
    Don't believe the stereotype - or should you?

    Don't believe the stereotype - or should you?

    We exaggerate regional traits and turn them into jokes - and those on the receiving end are in on it too, says DJ Taylor