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A whole new face

A whole new faceA Frenchman has a full face transplant.

At 30 years old Pascal Coler’s life has completely changed. The Frenchman could say he was born the second time thanks to a full face transplant. Mr. Coler's face had been horribly disfigured by Von Recklinghausen's disease, a rare genetic disorder. A year after the surgery, Mr Coler said that he is now free of the disease that at the age of six saw tumors begin to grow on his face. He also added that he hopes to find a wife, settle down and have children.

The nightmare started at the age of 6. He spent 24 YEARS horrifically disfigured by Von Recklinghausen's disease, a rare genetic disorder suffered over 100 years ago by Elephant Man Joseph Merrick — famously played by John Hurt in the hit movie.

Pascal was left unrecognizable by hideous bulbous tumors that engulfed his eyes, nose, and mouth with boil-encrusted, ulcerated skin.

But a team of French surgeons, headed by Professor Laurent Lantieri, gave him a new lease on life.

The controversial operation, which involved replacing Mr Coler's face with that of a dead donor, took 16 hours. Pascal said that the operation had revolutionized his life. He can live as a normal human being for the first time. People in the street look at him very differently, they no longer stop and stare or shout cruel words. Now he is accepted.

The man was lined up for the revolutionary op after dog attack victim Isabelle Dinoire was given the world's first partial face transplant in 2005.

But he was told his procedure would be much more dangerous and that he could die because he needed the world's first full face transplant. He was also told that in case if his body rejects the new face he could die in the theatre or afterwards. So it was not a question of using part of someone else's face to cover a wound, but of replacing one whole face with another.

He was always elated by his relatives and the doctor.

"The doctor used a line from the film Apollo 13, ‘Failure is not an option'."

On a cold January night Pascal was told a donor had been found. His cousin drove him to the Henri Mondor Hospital on the outskirts of Paris.

Pascal recalls: "When the anaesthetist began to prepare me for surgery I was feeling elated. My chance had finally come. Even with the risk of dying, there was no question of me hesitating."

His old friend Prof Lanteiri picked up his scalpel and looked at the face which over the years had undergone THIRTY ops to remove tumours and carry out plastic surgery.

And then he began slicing it away. First he cut off all the growths before carefully filleting the rest of Pascal's face, cutting over the left eyebrow, across and under the right one, and then down and around in a complete oval.

Prof Lantieri then had to lift the skin off and cut away flesh—some of it right down to the bone. He and his fellow doctors gasped in horror at what was left. This was a step into the dark...and they prayed as they took the donor's face and placed it over the hole.

Now Prof Lantieri and his team painstakingly connected tissues, nerves, arteries and veins before sending him back to the ward.

Pascal says: "When I came too my new face was not in bandages, but it was heavily swollen. My first proper meal after the operation was mashed potato and turkey. It felt very odd as my face was still numb. I had no problem eating it all, though."

The most moving moment for Pascal was when his mother Olga, 50, and younger sister Aurelie, 26, came to visit him.

"Both burst into tears of absolute happiness. It was one of the happiest days of their lives," he says, speaking in his native French.

"They are the rocks in my life—both absolute pillars of support. Whenever everything seemed impossible for me as I grew up, they made sure I kept going. Mum says I now look just like I did as a little boy." Until the age of six Pascal was just a normal child growing up in the Paris suburb of Argenteuil. "I was very ordinary and happy," he says.

But soon after his sixth birthday tumors began to grow on his face. "As things got worse I started to stay at home more and more," he says. "The tumors on my lips were so large and heavy it became very difficult to speak or eat.

"At school my classmates were made aware of my condition and never gave me any trouble at all. But the trouble happened with strangers when I went to places where I was not well known.

"There were awful times. People would not just stop and stare, some could not bear to be near me. I became a recluse.

"Once I was sitting quietly in a hospital waiting room when someone who looked at me fainted on the spot." Pascal had his first operations to remove tumors at the age of 12. "But in the early days they made very little difference," he says.

"In the meantime, I did the very best I could in all other aspects of my life. I played tennis and basketball, and had plenty of hobbies.

"I even traveled abroad when I was at school. There was a trip to Cardiff, which I loved. The Welsh people were very kind to me."

The brave teenager even won a place at university in Paris and did two years' vocational training in accountancy.

He says: "But despite all this, it was impossible for me to get a job afterwards. Nobody felt comfortable employing me. Despite my disability, I was only entitled to limited benefits. It was a struggle to survive."

But all those hard years were firmly put behind Pascal as he looked at his new face for the first time in a mirror six days after the transplant. "I whooped with joy. Seeing what the surgeons had done was quite incredible," he says. "I gave a V for Victory sign.

“I couldn't speak to begin with, but wrote my thoughts down. I wanted everyone to know how happy I was.”

"The crucial three weeks after the operation went very smoothly, with no rejection scares. Then I was slowly able to recuperate, exercising my new muscles and facial features."

When he got home from hospital, friends and neighbors were waiting to greet him.

"My operation was meant to have been a secret, but everybody in our neighborhood had heard rumors about it.

"When I got out of the ambulance, there was a huge crowd waiting. They were all cheering and shouting, ‘Well done'. It was very touching indeed." It made him smile—something he hadn't been able to do for 24 years. "The flexibility and feeling gets better every day," he says.

"Ten months after the initial operation I underwent another op in which dental titanium implants were put in to give me new teeth."

Now, a year after the operation, tests have showed that Pascal is now completely free of the Elephant Man disease since the affected tissue was taken away.

He is about to start work as an accountant and is thinking about playing tennis and basketball again. He hopes to find a wife and have children.

"One of the main reasons I know the operation was a great success is because I now dream about myself in my new face, not the old one," he says. "Professor Lantieri says this is a sure sign that things are going well. This week I begin my first job with an accountancy firm. I'm also enjoying socializing with my friends. Life really is going pretty well for me at the moment."

Outside of the professor and his team and Pasacal's mother and sister, the person he will always be thankful to is the man whose face he now wears.

He will never know who his donor was—unless the family chooses to come forward.

Pascal says: "All the details of the donor have been kept a secret, and I think this is the right thing.

"But there is not a day goes by when I do not pray for the person who gave me a new face—and a new life."

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