Are we ready for face-swaps?

A senior London plastic surgeon today called for a debate on whether face transplants should be allowed - a procedure that could be possible in six months.

The process of being able to graft the face from a dead donor on to another person is now a real possibility following the emergence of new techniques and improved drugs.

Consultant plastic surgeon Peter Butler is to lead a debate on the issue at the British Association of Plastic Surgeons today. He said it was " essential" for a full public moral and ethical debate on face transplants before anyone underwent the operation.

Mr Butler, who works at the Royal Free in London, said: "It is not can we do it? But should we do it?"

Until recently the technique, which featured in the Hollywood thriller Face/Off, was dismissed as science fiction. In the 1997 film John Travolta and Nicolas Cage swapped faces.

Mr Butler said: "Those who have suffered severe facial deformities from burns, cancer patients who have had facial surgery or people who have been disfigured in accidents could benefit."

He said techniques already in place to carry out such operations could mean the procedure could be performed within the next six to nine months.

But Mr Butler added that a more realistic time frame would be around 18 months, because the issue would probably take some time to discuss.

A face transplant would include a lengthy operation where eight blood vessels, four arteries and four veins would have to be removed from a donor.

The patient receiving the face transplant would then need their facial muscles and skin removed for the operation.

Mr Butler said it is difficult to reconstruct a patient's face, because it needs to move to convey expressions and feelings, especially with eyes, lips and cheeks. Taking skin from other parts of the body which happens in other types of operations now, would not allow sensitivity or movement and would end up creating a "mask-like" effect. He said said face transplants involving muscle and nerves as well as skin would allow the face to move.

Mr Butler said serious concern had already been raised by nurses, doctors and church ministers about face transplants.

He added: "While people would, in general, accept a face transplant if they required it, they would actually not be willing to donate.

"In the end I think that technically, we will be able to do this in the next 18 months.

"But it's whether we should do it.It's the moral and ethnic debate that needs to be raised in a public way, to find out what the issues are that need to be addressed to make it possible."

Mr Butler said the number of patients having a face transplant would be small, only around 10 to 15 patients in the country who might be eligible for the operation.

Following more research, Mr Butler plans to ask permission to carry out a face transplant at the London hospital, a request that would have to go before the Department of Health.