Key to tomorrow's youthful look

Today's science fiction is tomorrow's cosmetic surgery. The suggestion that face transplants could become a reality raises the prospect of the ageing rich raiding the cadavers of beautiful 20-year-old accident victims for a new, young look.

Just as the extraordinary techniques developed 50 years ago by Sir Harold Gillies, the father of plastic surgery, for treating badly burnt Second World War bomber pilots have metamorphosed into nips and tucks for the pampered rich, so new methods being developed for today's accident victims may find a place in the beauty salons of the 21st century.

Could Cindy Jackson, 42, who underwent 27 operations at a cost of pounds 60,000 have saved herself the trouble with a single face transplant?

Although face transplants are technically possible, their introduction is held up by problems of rejection. Powerful immunosuppressant drugs are not justified for non-life-threatening conditions and even disciples of self-improvement such as Ms Jackson would draw the line at taking potentially toxic doses.

James Frame, consultant plastic surgeon at St Andrew's hospital, Essex, who has been doing research in the area for four years, said: "What the transplant world is waiting for is a way of overcoming the rejection problem without drugs."

The best candidate is "transfection" - a method of transferring genes to the new tissue, using a virus as a carrier to "infect" it, ensuring that it is accepted by the recipient of the transplant.

Mr Frame said the first candidates for a face transplant, were it to become possible, would be cancer patients. "If someone has surgery for cancer of the mouth the best we can do for them is lift a section of skin from their back and transfer it to their face. The results are not very good. I feel as a cosmetic surgeon we ought to be able to offer them something better."

But creating a new look for the vain would be more difficult than replacing skin and underlying tissue with someone else's face. Mr Frame said: "It can't be done. The skeleton would still be there. Because of that basic background, whatever you put over the top you would still be left with the same individual."

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