She is still unable to move her lips fully and her speech remains slurred. But the world's first face transplant patient said yesterday that the controversial operation had given her back "a normal life".
Speaking publicly for the first time since undergoing surgery, Isabelle Dinoire thanked her doctors and told a packed press conference: "Now I have a face like everyone else."
Ms Dinoire, from Valenciennes, north of Amiens, lost her nose, lips and chin when her pet cross-labrador dog mauled her face as she slept in May last year. She made medical history when she was given a partial face transplant using tissue from a brain-dead woman in a 15-hour operation at Amiens hospital in November. The team that carried out her face transplant has asked French authorities for permission to carry out five similar operations.
Ms Dinoire appeared terrified as she entered the conference hall to a round of applause and the flicker of flashlights. Someone called out: "Mademoiselle" - a word normally reserved for under-25s - and the 38-year-old mother-of-two's eyes smiled while the edges of her mouth quivered slightly with pleasure. Even under harsh lights, the triangular scar marking the edge of the transplanted skin was barely visible. Although she seemed unable to close her mouth, at one point she took a drink of water from a plastic cup.
Ms Dinoire thanked her medical team and the family of the donor. She explained how her face was terribly disfigured in what she described as "an accident. On May 27 after a very disturbing week and lots of personal worries, I took some tablets to forget. Then I felt faint and I passed out. When I woke up I tried to light a cigarette and I couldn't understand why I couldn't hold it between my lips. It was then I saw a pool of blood and the dog next to me. I went to look in the mirror and I was horrified. I couldn't believe what I saw, especially as I didn't feel any pain. Since that day my life has changed."
She said she did not leave her room in hospital for six weeks because "I was afraid of other people's looks". She could not eat normally because she was unable to open her mouth more than 3mm.
"Now I can open my mouth and eat. Since recently I can feel my lips, my nose and my mouth." She hoped to pick up her family life with her two daughters and to work again, adding: "I also hope my operation will help other people injured like me to live again." As Professor Bernard Devauchelle, one of the surgeons involved in the pioneering transplant, described the operation, photographs of Ms Dinoire's disfigured face before surgery were shown on a screen behind the stage. Ms Dinoire stared firmly ahead.
Prof Devauchelle rejected critics who said the transplant had been rushed, saying the patient had been prepared for six months beforehand. He said Ms Dinoire had eaten food by mouth just seven days after the transplant, which involved skin, muscles, nerves and blood vessels. Explaining why the patient was unable to move her lower lip, he said muscular movement was the most difficult to restore but was happening slowly.
Fellow transplant surgeon Professor Jean-Michel Dubernard said the moment he saw Ms Dinoire's terrible injuries he had no doubt about the operation.
"At first when I was called I dragged my heels as I knew how hard it would be. I was very hard to Isabelle, even brutal, when I explained the risks of the transplant. I wanted to verify the information we gave her was well understood," he said. "At the time she was wearing a mask and afterwards she took off her mask and I had no hesitation. That was the moment I knew we were doing the right thing."
Prof Dubernard, who also carried out the world's first hand transplant, said three weeks after the operation there were signs that the transplant was being rejected, requiring high doses of drugs to suppress the patient's immune system.
"At the moment everything is going well. But because this is a first we absolutely cannot give any prognosis for the future," he said. Ms Dinoire undergoes daily tests and weekly sessions with a psychiatrist. Despite doctors' advice she has started smoking again.
