US doctors prepare for first human face transplant [Archive]

QueEx

09-19-2005, 03:38 AM

<font size="5"><center>US doctors prepare for first human face transplant </font size>
<font size="4">Clinic to select patient after getting go-ahead
Critics warn of serious mental and medical risks </font size></center>

Dan Glaister in Los Angeles
Monday September 19, 2005
The Guardian

Doctors at a US clinic will start interviewing potential recipients for the world's first face transplant in the next few weeks, after winning approval from the clinic's internal review board.

The medical team at the Cleveland Clinic in Ohio is led by Maria Siemionow, a 55-year-old surgeon who has spent years conducting research into face transplants, including experiments on animals and human cadavers.

"You want to choose patients who are really disfigured, not someone who has a little scar," she told Associated Press.

The procedure is intended to help patients whose faces are disfigured because of an accident or genetic fault. Many patients spend years enduring painful reconstructive surgery. It is a process that has been labelled "life by 1,000 cuts".

Proponents of face transplants argue that the procedure could remove the need for years of operations by applying a new sheet of skin in one operation. While the capability to perform face transplants has existed for years, nobody has attempted it. Teams of surgeons in Britain, France and the US have previously announced that they are close to performing face transplants, but concerns over the ethical implications of the procedure have halted or delayed their plans.

Although the Cleveland Clinic team has won approval from an internal review board, critics say an independent review board should determine whether the procedure can go ahead.

Last year a team at the University of Louisville in Kentucky, which had successfully transplanted a human hand, decided not to go ahead with face transplants after examining the ethical issues. "At stake is a person's self-image, social acceptability and sense of normalcy," wrote Osborne Wiggins, a philosophy professor and clinical investigator at the university, in the American Journal of Bioethics.

In the same journal, Carson Strong, a bioethicist at the University of Tennessee, wrote: "It would leave the patient with an extensive facial wound with potentially serious physical and psychological consequences."

But Dr Siemionow's team argues that the possible gains are worth the risk involved. "Really, who has the right to decide about the patient's quality of life?" she asked. "It's very important not to kind of scare society ... We will do our best to help the patient."

The operation is expected to last up to 24 hours hours. A "skin envelope" from a donor is attached to the recipient using one or two pairs of veins and arteries on either side of the face. About 20 nerve endings would also be attached.

The recipient should look similar to the way they did before the operation, the Cleveland Clinic tells potential donors and patients. This is because the skin is grafted on to existing bone and muscle, which determine the shape of a face. Similarly, expressions and facial characteristics are determined by the brain, and are not the product of facial tissue.

Other researchers suggest, however, that the final result will resemble a combination of the recipient and the donor.

Opponents are most concerned about the possibility of rejection of the transplanted tissue and cultural and ethical problems. They are also concerned that the procedure, if successful, could be exploited for cosmetic surgery. Should the recipient's body reject the transplant, it raises the possibility that the patient will be left worse off than before.

Many critics also question whether a person already traumatised by facial disfigurement would be equipped to cope. Although the Cleveland Clinic tells prospective recipients that it will do its best to shield their identity, it concedes that the press will probably discover it. The clinic also tells patients that the risks are so unknown it does not think informed consent is possible.

Dr Siemionow and her team expect to interview five men and seven women in the coming weeks. But she warned that applicants should not have unrealistic expectations about the results.

"It's not a shopping mall," she said. "They need to rely on our judgment. If they are starting to shop, they are not good candidates."

How the operation works

How would doctors carry out a face transplant?

Surgeons would need to take all the skin from the donor's hairline to jawline and from ear to ear. They would also save the nose, mouth, lips, eyebrows and eyelids and ensure that the muscles, the layer of fat and the nerves were still attached. Along with eight blood vessels, each element of the donated face would have to be carefully reconnected in a surgical procedure that could last up to 24 hours.

Who would the patient look like?

Not like the donor. The skin tone, texture and hair colour of the donor would be transferred but the patient's own bone structure would determine what their new face would look like.

How long would it take to recover?

The recipient of a new face might have to stay in hospital for several weeks. In addition, patients would have to take drugs to suppress their immune system (which would otherwise attack the new face as it is foreign tissue) for the rest of their lives.

Have we been here before?

In 2004, a team from the University of Louisville in Kentucky submitted a request to their ethical committee to carry out what would have been the first face transplant in the world. Two years before that, scientists in Britain had discussed the ethics of such operations amid concerns that the first transplants would be carried out later that year.

http://www.guardian.co.uk/usa/story/0,12271,1573300,00.html

QueEx

09-19-2005, 03:45 AM

<font size="6"><center>Face-off over facial transplants</font size>
<font size="4">Doctors prepare for surgery, but key questions remain</font size></center>

<center>http://msnbcmedia.msn.com/j/msnbc/Components/Photos/040602/040602_face_hmed_1230p.hmedium.jpg
An illustration shows the stages of a face transplant. Surgeons from the University of
Louisville in Kentucky are in the process of requesting formal permission to perform the
controversial procedure.</center>

By Arthur Caplan
COMMENTARY
MSNBC
Updated: 8:45 a.m. ET June 3, 2004

A team of doctors at the University of Louisville in Kentucky is moving forward with a plan to attempt the world’s first face transplant. They have applied for permission from the University’s research ethics committee to remove a face from a cadaver and transfer it to a live volunteer willing to go through with the surgery. If approved, the operation could take place before the end of this year.

For those who have suffered terrible physical trauma, such as burns or the ravages of oral cancer, and who have been unable to adjust to their disfigurement, this radical new form of surgery offers tremendous hope. However, the ethical question is whether these surgeons are really ready to offer this hope.

The reason the team at Louisville believes they are prepared to try this incredible operation is that they have already been successful in transplanting hands taken from cadavers. To date, one of the most difficult tissues to transplant is skin. The body’s first line of defense is especially sensitive to foreign tissue and, as a result, skin transplants have limited what could be done with limbs, hands or other external organs. The Louisville group has developed a powerful combination of drugs that helps prevent the body from rejecting transplanted skin, allowing for their success with hand transplantation. The team believes they can apply this technique to face transplants as well.

Patient faces enormous risk
There are apparently many volunteers willing to undergo a face transplant. While some people who have endured facial disfigurement learn to adjust, others do not. They would gladly take the risks involved in such a surgery for a chance to regain the normalcy that, in our appearance-conscious society where people undergo multiple surgeries just to look younger, is difficult to achieve with a severely deformed face.

The problem is that there are a number of very real and serious risks confronting the first subject. For example, the drugs used to prevent rejection by the body may fail, leaving the recipient with the nightmare of the transplant being rejected and, with death likely to quickly follow, no other options. In addition, the drugs involved are so toxic that cancer, kidney failure and other problems are likely to eventually occur, even if the initial surgery is successful.

Even more challenging is the problem of adjusting to a new face. While those with severe facial deformities might hope for any alternative, a transplanted face that does not work right, looks strange or reminds people of someone who is dead, would pose very difficult challenges to anyone who receives it.

Should donor's family help decide?
And how will a donor be selected? Remember -- until you know who your pool of recipients is likely to be, you cannot match possible donors for blood type, size and other biological factors. As a result, the decision about who will donate and who will undergo the surgery is likely to be a last-minute one.

Should the pool of possible donors only include those who have signed a donor card or who sign a document including their face among those organs and tissues they are willing to give? Or should their families be able to make the decision without a donor card since they are the ones who will have to live with whatever happens when the surgery is completed and someone else receives their loved one’s face?

These are among the most difficult ethical questions ever to confront the field of transplantation. Thankfully, the Louisville team is trying to explore and discuss these issues before they proceed. Let’s hope that they -- and other surgical teams in the United States, France and Britain who are also gearing up to be the first to perform this unprecedented procedure -- have the good judgment not to proceed until all of these questions have been answered.

Arthur Caplan is director of the Center for Bioethics at the University of Pennsylvania.

http://www.msnbc.msn.com/id/5122174/

QueEx

09-19-2005, 03:51 AM

Yo gene cisco ... lol

CNN
Saturday, September 17, 2005; Posted: 10:22 p.m. EDT (02:22 GMT)

CLEVELAND, Ohio (AP) -- In the next few weeks, five men and seven women will secretly visit the Cleveland Clinic to interview for the chance to have a radical operation that's never been tried anywhere before.

http://www.cnn.com/2005/HEALTH/09/17/face.transplant.ap/index.html

.

QueEx

09-19-2005, 04:04 AM

<font size="4">
Could you do this ???

Is this unethical ???</font size>

http://64.255.174.200/board/images/icons/icon5.gifhttp://64.255.174.200/board/images/icons/icon5.gifhttp://64.255.174.200/board/images/icons/icon5.gif
.

broken sword

09-19-2005, 05:35 AM

Could I do this??

I don't know. But, I'm not in that predicament. I can only imagine what it would be like to have that type of facial disfigurement. I've seen a few people with that type of disfigurement, and all of them SEEMED to be depressed about their condition. The case that stands out to me, was a woman that I saw on the C train (New York), her skin was hanging off of her body, and every part of her skin that was exposed was covered with huge pimples. If I had to live like that, or walk around with my face scarred in that manner a facial transplant might be a dream come true. I think that if there were minimal side effects, I would opt for the surgery, but without those assurances I wouldn't go through with the operation.

Is it unethical??

Is it ethical to make a patient more supseptible to disease? Personally, the actual procedure doesn't bother me. As long as the donor previously agreed to donate their face, they will probably make that an option for people to check off. The family doesn't have much say in it if the person previously agreed to be a donor. The drugs that supress the immune system concern me. This would expose the patient to a host of problems, and I believe (I may be mistaken) that it will limit their daily activities. I think it's an unethical procedure, if the patient would be required to take these drugs. Alot of the people who are disfigured will perform the procedure, regardless of the risks, and that could potentially be life threatening.

connectz

09-19-2005, 10:04 AM

And the first recipient iiiiisssssssssss...

This

http://www.cnn.com/WORLD/africa/9808/22/air.strikes.follow/link.bin.laden.jpg

To this!!

http://www.cnn.com/SPECIALS/2001/bush.100/images/cut.row2.col4.bush.pic.jpg

dockoldheart

09-19-2005, 11:44 PM

Is it ethical to make a patient more supseptible to disease? Personally, the actual procedure doesn't bother me. As long as the donor previously agreed to donate their face, they will probably make that an option for people to check off. The family doesn't have much say in it if the person previously agreed to be a donor. The drugs that supress the immune system concern me. This would expose the patient to a host of problems, and I believe (I may be mistaken) that it will limit their daily activities. I think it's an unethical procedure, if the patient would be required to take these drugs. Alot of the people who are disfigured will perform the procedure, regardless of the risks, and that could potentially be life threatening.

i agree 100% it's the drugs that bother me. just seems like a bad idea.

Could I do this??
naw.. i'm happy with the ugly mug god gave me.
i also wouldn't want someone walkin round with my face.... so i wouldn't be a donor.

QueEx

12-02-2005, 08:12 PM

QueEx

12-06-2005, 01:19 AM

QueEx

04-15-2006, 11:28 AM

<font size="5"><center>Chinese man 'has world's second face transplant'</font size></center>

http://www.telegraph.co.uk/news/graphics/2006/04/15/wface15.jpg
A surgeon shows photos of the man before the op

By Roger Highfield, Science Editor
(Filed: 15/04/2006)

A Chinese military hospital said yesterday that it had performed the world's second face transplant.

A 30-year-old man, who had been attacked and disfigured by a black bear while hunting, had two thirds of his face replaced in an operation lasting 14 hours.

Xijing Hospital in the north-western city of Xi'an said on its website that it had performed the surgery after two years of preparation.

"The surgery is even more complex than the first face transplant in France in November last year," said Han Yan, the deputy director of plastic surgery.

The recipient was Li Guoxing, of the Lisu ethnic minority in the south-western province of Yunnan, who was disfigured two years ago.

"Up to now, the patient is in good condition," the hospital said. It would take six months for feeling to be restored to the new face.

Isabelle Dinoire, 39, of Valenciennes, north France, was the first person to receive a face transplant.

http://www.telegraph.co.uk/news/main.jhtml;jsessionid=YHXTPZ24KXTGNQFIQMFSFGGAVCBQ 0IV0?xml=/news/2006/04/15/wface15.xml&sSheet=/news/2006/04/15/ixnewstop.html

QueEx

08-23-2008, 06:41 AM

QueEx

08-23-2008, 06:42 AM

keysersoze

08-23-2008, 12:58 PM

wow.

itwazuntme

08-23-2008, 01:18 PM

<font size="5"><center>US doctors prepare for first human face transplant </font size>
<font size="4">Clinic to select patient after getting go-ahead
Critics warn of serious mental and medical risks </font size></center>

Dan Glaister in Los Angeles
Monday September 19, 2005
The Guardian

Doctors at a US clinic will start interviewing potential recipients for the world's first face transplant in the next few weeks, after winning approval from the clinic's internal review board.

The medical team at the Cleveland Clinic in Ohio is led by Maria Siemionow, a 55-year-old surgeon who has spent years conducting research into face transplants, including experiments on animals and human cadavers.

"You want to choose patients who are really disfigured, not someone who has a little scar," she told Associated Press.

The procedure is intended to help patients whose faces are disfigured because of an accident or genetic fault. Many patients spend years enduring painful reconstructive surgery. It is a process that has been labelled "life by 1,000 cuts".

Proponents of face transplants argue that the procedure could remove the need for years of operations by applying a new sheet of skin in one operation. While the capability to perform face transplants has existed for years, nobody has attempted it. Teams of surgeons in Britain, France and the US have previously announced that they are close to performing face transplants, but concerns over the ethical implications of the procedure have halted or delayed their plans.

Although the Cleveland Clinic team has won approval from an internal review board, critics say an independent review board should determine whether the procedure can go ahead.

Last year a team at the University of Louisville in Kentucky, which had successfully transplanted a human hand, decided not to go ahead with face transplants after examining the ethical issues. "At stake is a person's self-image, social acceptability and sense of normalcy," wrote Osborne Wiggins, a philosophy professor and clinical investigator at the university, in the American Journal of Bioethics.

In the same journal, Carson Strong, a bioethicist at the University of Tennessee, wrote: "It would leave the patient with an extensive facial wound with potentially serious physical and psychological consequences."

But Dr Siemionow's team argues that the possible gains are worth the risk involved. "Really, who has the right to decide about the patient's quality of life?" she asked. "It's very important not to kind of scare society ... We will do our best to help the patient."

The operation is expected to last up to 24 hours hours. A "skin envelope" from a donor is attached to the recipient using one or two pairs of veins and arteries on either side of the face. About 20 nerve endings would also be attached.

The recipient should look similar to the way they did before the operation, the Cleveland Clinic tells potential donors and patients. This is because the skin is grafted on to existing bone and muscle, which determine the shape of a face. Similarly, expressions and facial characteristics are determined by the brain, and are not the product of facial tissue.

Other researchers suggest, however, that the final result will resemble a combination of the recipient and the donor.

Opponents are most concerned about the possibility of rejection of the transplanted tissue and cultural and ethical problems. They are also concerned that the procedure, if successful, could be exploited for cosmetic surgery. Should the recipient's body reject the transplant, it raises the possibility that the patient will be left worse off than before.

Many critics also question whether a person already traumatised by facial disfigurement would be equipped to cope. Although the Cleveland Clinic tells prospective recipients that it will do its best to shield their identity, it concedes that the press will probably discover it. The clinic also tells patients that the risks are so unknown it does not think informed consent is possible.

Dr Siemionow and her team expect to interview five men and seven women in the coming weeks. But she warned that applicants should not have unrealistic expectations about the results.

"It's not a shopping mall," she said. "They need to rely on our judgment. If they are starting to shop, they are not good candidates."

How the operation works

How would doctors carry out a face transplant?

Surgeons would need to take all the skin from the donor's hairline to jawline and from ear to ear. They would also save the nose, mouth, lips, eyebrows and eyelids and ensure that the muscles, the layer of fat and the nerves were still attached. Along with eight blood vessels, each element of the donated face would have to be carefully reconnected in a surgical procedure that could last up to 24 hours.

Who would the patient look like?

Not like the donor. The skin tone, texture and hair colour of the donor would be transferred but the patient's own bone structure would determine what their new face would look like.

How long would it take to recover?

The recipient of a new face might have to stay in hospital for several weeks. In addition, patients would have to take drugs to suppress their immune system (which would otherwise attack the new face as it is foreign tissue) for the rest of their lives.

Have we been here before?

In 2004, a team from the University of Louisville in Kentucky submitted a request to their ethical committee to carry out what would have been the first face transplant in the world. Two years before that, scientists in Britain had discussed the ethics of such operations amid concerns that the first transplants would be carried out later that year.

http://www.guardian.co.uk/usa/story/0,12271,1573300,00.html

This article is 3 years old, do you have any more recent resources. I believe this face transplant was deemed a success, although I have not heard any information regarding the progress of the patient.

troutwine

09-04-2008, 01:39 PM

interesting thread...

QueEx

12-18-2008, 09:48 AM

<font size="6"><center>A - B G O L - E X C L U S I V E</font size></center>

<IFRAME SRC="http://www.chinadaily.com.cn/english/doc/2005-12/06/content_500704.htm" WIDTH=780 HEIGHT=1500>
<A HREF="http://www.chinadaily.com.cn/english/doc/2005-12/06/content_500704.htm">link</A>

</IFRAME>

<font size="5">UPDATE:</font size>
<font size="3">

The first facial transplant recipient has gone from
looking like this just a few months after surgery:

http://www.cbc.ca/gfx/pix/dinoire_isabelle_CP_9456222.jpg</font size>
Isabelle Dinoire Eighteen months after ("]speaks to reporters[/url]
in February 2006 during her first press
conference after her facial transplant.
(Michel Spingler/Associated Press)

<font size="3">To this:
</font size>

http://www.smh.com.au/ffximage/2007/12/13/isabelle_dinoire_narrowweb__300x382,0.jpg
[url="http://www.google.as/imgres?imgurl=http://www.smh.com.au/ffximage/2007/12/13/isabelle_dinoire_narrowweb__300x382,0.jpg&imgrefurl=http://www.smh.com.au/news/world/face-transplant-stays-put/2007/12/13/1197135655597.html%3Fs_rid%3Ddrive:promostrip:cont ent2&h=382&w=300&sz=31&tbnid=JlV8yqw5aRyeuM::&tbnh=123&tbnw=97&prev=/images%3Fq%3Disabelle%2Bdinoire&usg=__QeUPfeYSmJZcgUiQcLuHMHXOGJw=&sa=X&oi=image_result&resnum=7&ct=image&cd=1) receiving a new nose,
chin and lips, the world's first face transplant
recipient has recovered enough use of her
facial muscles to close her lips and smile.

`

QueEx

12-18-2008, 09:52 AM

<font size="5"><center>US doctors prepare for first human face transplant </font size>
<font size="4">Clinic to select patient after getting go-ahead
Critics warn of serious mental and medical risks </font size></center>

Dan Glaister in Los Angeles
Monday September 19, 2005
The Guardian

Doctors at a US clinic will start interviewing potential recipients for the world's first face transplant in the next few weeks, after winning approval from the clinic's internal review board.

The medical team at the Cleveland Clinic in Ohio is led by Maria Siemionow, a 55-year-old surgeon who has spent years conducting research into face transplants, including experiments on animals and human cadavers.

<font size="5">

UPDATE:
</font size>

<IFRAME SRC="http://www.theage.com.au/world/doctors-hail-first-us-face-transplant-20081218-713m.html" WIDTH=780 HEIGHT=1500>
<A HREF="http://www.theage.com.au/world/doctors-hail-first-us-face-transplant-20081218-713m.html">link</A>

</IFRAME>

QueEx

05-05-2009, 07:41 PM

<font size="5"><center>
First U.S. face transplant recipient offers thanks</font size></center>

http://i2.cdn.turner.com/cnn/2009/HEALTH/05/04/face.transplant.patient/art.bf.clv.cln.jpg
Before Shotgun Blast

C a b l e N e w s N e t w o r k
By Madison Park
May 5, 2009

In 2004, a bullet ripped away Connie Culp's nose, cheeks and upper jaw. Metal fragments sprayed into her skull and stripped her face away, leaving nothing except for her eyes, her chin and forehead.

Without her nose, she could not smell. She breathed through a tracheostomy -- a surgical opening in her neck. Without lips, she could barely speak.

But Tuesday, when Culp, 46, the first recipient of a face transplant in the United States, stepped in front of the cameras at a news conference, she was whole.

In a soft voice, the Ohio mother of two repeatedly thanked the medical staff and the deceased donor whose nose, upper lip, cheekbones are now hers.

"I want to focus on the donor family that allowed me to have this Christmas present," she told reporters gathered at the Cleveland Clinic, where her surgery took place.

In December, Culp underwent a 22-hour transplant surgery. Although the hospital announced the facial transplant at that time, the patient had remained anonymous until the news conference.

During the surgery, tissue from a deceased donor's face was shaped and fitted into position. Multiple layers of tissue, bone, muscle and blood vessels, nerve grafts and each artery and vein were connected. Culp received a nose, lower eyelids and upper lips, as doctors filled in the missing components of her face.

Culp could not yet move her facial muscles to form a smile, but she laughed.

"Well, I got me my nose." she quipped.

Two months after the surgery, Culp was discharged from the hospital and returned home. Before the surgery, Culp could not eat solid foods. She could not taste.

"Connie can now enjoy her food," said Dr. Maria Siemionow, who led the transplant operation. "She eats hamburgers and enjoys her pizzas, she's drinking coffee from the cup."

Her new face allows her to "blend with society."

"As you can see we have now a healthy person and happy person," Siemionow said. "She has reduced dramatically her pain and also she's able to walk on the street without being called names."

Since the operation, doctors say Culp's new face has developed more movement. The new facial nerves are growing slowly, about an inch a month.

"While Connie can do several things now that she was unable to do in the past, as time goes on more and more of the facial nerves will grow," said Dr. Frank Papay, chairman of the Dermatology and Plastic Surgery Institute at the Cleveland Clinic. "She will become more animated."

For years, Culp lived "in tremendous pain, chronic pain, over the entire time," said Siemionow, director of plastic face transplant surgery research and head of microsurgery training at the hospital.

Culp told a local television station in a 2008 interview that she had been shot in the face from just eight feet away in an attempted murder-suicide by her husband.

In 2005, Culp came to the Cleveland Clinic for treatment. After 30 surgical procedures, none had restored her basic functions.

"The last resort and the last option was to consider face transplantation," said Siemionow. Transplant recipients have to take immunosuppressing, anti-rejection drugs for the rest of their life.

After the hospital's surgeons, ethical committee members, psychiatry and psychology specialists met with Culp, they decided "that Connie is the right patient," Siemionow said.

Doctors involved in Culp's treatment said the surgery was not about aesthetics, but to restore Culp's basic abilities.

"We are actually overwhelmed by how great she's doing functionally," Siemionow said. "And I'm re-emphasizing that this is all about functional outcome. Someone who couldn't breathe through the nose, who couldn't eat solid foods, didn't have a palate or not able to drink from a cup. ... So if she can do all these functions that are taken for granted on a daily basis, this is amazing."

Although there is a risk Culp's body could still reject the transplant, the doctors said they have not seen such signs.

Some critics say face transplants are unnecessary, because they are risky procedures involving a lifetime of immunosuppressants, that do not save a person's life, but improve an individual's appearance. Previous face transplants performed in Europe and Asia generated controversy. A Chinese man whose face was disfigured in a bear attack died of unknown causes two years after receiving the face transplant.

The fact that Culp regained some of her basic functions highlights that "this is not cosmetic surgery in any sense of the word," said Dr. Eric Kodish, the professor and chairman of the Cleveland Clinic's Department of Bioethics. "We remain convinced about the ethical justification for the face transplant in this and potentially in other cases in the future."

Ultimately, the face transplant affords an individual's "right to decide what kind of life they want to live." Many with facial disfigurements are called names, can't go out in public or wear masks to hide their face, said Siemionow.

In Culp's case, it was a matter of restoring basic physical abilities.

"If you can breathe through your nose in the spring in Cleveland, isn't that amazing?" said Siemionow.

Culp will require a few more cosmetic procedures, for example to remove excess skin from her face.

Culp read a statement and did not take questions. She told reporters in the news conference that she had been shot and said, "I don't want to go into it."

Then she asked the public to have empathy for people with facial disfigurements.

"When somebody don't look as pretty as you do, don't judge them," she said. "You don't know what might happen to you. Don't judge the people who don't look the same way as you do. You never know when it may be taken away from you."

http://www.cnn.com/2009/HEALTH/05/04/face.transplant.patient/index.html

QueEx

05-05-2009, 07:49 PM

<font size="6">

<center>

WARNING

GRAPHIC

CONTENT

VIEWER DISCRETION ADVISED

</font size>

<center>

<IFRAME SRC="http://www.cnn.com/2009/HEALTH/05/04/face.transplant.patient/index.html#cnnSTCPhoto" WIDTH=780 HEIGHT=1500>
<A HREF="http://www.cnn.com/2009/HEALTH/05/04/face.transplant.patient/index.html#cnnSTCPhoto">link</A>

</IFRAME>