Isabelle Dinoire

Isabelle Dinoire, born 1967, was the first person to undergo a partial face transplant, after her Labrador dog mauled her in May 2005. Prior to the operation, she could barely eat or speak, but after the operation, she can do both.

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Personal life

Isabelle Dinoire lives in Valenciennes, northern France. She is divorced and has two teenage daughters.

According to The Australian, she has signed a contract with British documentary maker Michael Hughes that could make her more than £100,000 from the sale of photographs and a film of the operation.

Mutilation incident

Some reports claim that her daughter said that the black Labrador cross (named Tania) was trying to wake Dinoire after she took sleeping pills in a suicide attempt. The hospital denied this. However, in a statement made on February 6 2006, Dinoire admitted that "after a very upsetting week, with many personal problems, I took some pills to forget ... I fainted and fell on the ground, hitting a piece of furniture."^[1]

The family is sure that the dog, which has since been put down, mutilated Isabelle by accident. They believe that the damage was caused when the dog, finding she wouldn't wake up, got more and more frantic, and began scratching and clawing her.^[2]

Partial face transplant

The world's first ever partial face transplant on a living human was carried out on Dinoire on November 27 2005  by Professor Bernard Devauchelle the surgeon who performed the first successful partial face transplant assisted by Professor Jean-Michel Dubernard in Amiens, France. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient.^[3][4] "Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant."^[5]

A debate over the ethics of the operation emerged, however, after it was alleged that Dinoire's face had been ravaged by her labrador while she was asleep after attempting suicide by excessive consumption of sleeping pills; and that her donor, Maryline St. Aubert, 46, had herself committed suicide by drowning herself in her toilet. Concern was raised over Dinoire's ability to consent to the transplant, considering her mental state. Dubernard strenuously denied that Dinoire had attempted suicide, while Devauchelle insisted he would not have conducted the transplant if he had known that St. Aubert had hanged herself, as he feared the blood vessels in her face would be damaged.^[6]

Recovery

Whether the challenging surgery will be proven successful in the long run is yet to be seen. It was reported on January 18, 2006 that Dinoire has used her new lips to continue smoking, which doctors fear will cause the face tissue in her transplant to be rejected.^[7]

There has been a change in her appearance. Her original face had a wide, tilted nose, a prominent chin and thin lips. The donated face has given her a straight and narrow nose, a neater chin and a fuller mouth. Dinoire appeared in a press conference on February 6, 2006, which showed that she had partial control over the transplanted muscles, although she appeared unable to close her mouth fully.

Exactly one year following the partial face transplant, Dinoire stated she has the ability to smile again. On November 28, 2006, Dinoire's surgeon, Bernard Devauchelle, said that over the past year Dinoire’s scars have become far less prominent.^[8]

Associated Press released a picture of Isabelle Dinoire on November 28, 2006, one year after the operation. The French newspaper "Le Monde" website explained on December 2, 2006 that Associated Press had eliminated the picture, because "The hair of Isabelle Dinoire and the background of this image were manipulated by the source."

For the two year anniversary, her doctors published an article in the New England Journal of Medicine detailing her operation and recovery. Complications have included kidney failure and two episodes of tissue rejection, which have been suppressed by drugs. Dinoire will have to take the drugs the rest of her life, raising the question of whether she can do so reliably; a Boston doctor said if she stopped, it would be a "disaster", with the new face sloughing off over time.^[9]

Images

• Preoperative, premauling image of Isabelle Dinoire
• Post-mauling, pre-transplant image of Isabelle Dinoire
• Postoperative image of Isabelle Dinoire
• Immediately postoperative image of Isabelle Diniore compared with one year later

References