First total face transplant performed in Spain

— MADRID - A Spanish hospital says it has performed the world's first complete face transplant on a man who lost his jaw, nose and cheeks, and who couldn't speak or eat by himself, according to El Pais newspaper.

"We thank the patient for his trust — this is a life or death operation," said Pere Barret, head of burns and plastic surgery at Vall d'Hebrón hospital in Barcelona, the newspaper reported.

The patient has seen himself in a mirror and is satisfied with the results, Barret was quoted as saying.

The patient still cannot eat on his own and needs help breathing, the doctor said.  In order to regain key functions and recover the ability to speak, breath and even smile, he will have to go through a rehabilitation plan.

The March operation on the man in Barcelona, who lost his face in an accident five years ago and has undergone nine previous operations, involved 30 medical professionals and lasted 24 hours, the newspaper reported.

The Times of London said the man was a farmer, in his 30s, who accidentally shot himself in 2005.

The patient is doing well, the doctors told a press conference, although he is still not eating alone in order not to force his facial muscles, El Pais reported.

While 11 other face transplants have been performed around the world, the the hospital said these only involved parts of the patients' faces.

During the operation, doctors extracted the donor's face, and then removed the jaw, nose, cheeks and parts of the eye cavities. Then the medical team took all of the donor face's soft tissue, including musculature, veins and nerves — things that "give mobility to the face, the eyelids and mouth," Barret told reporters, according to the newspaper.

Meanwhile, the recipient was being prepared by extracting deformed parts of his face and making sure his immune system would not not reject the transplant, the doctor explained.

In order to transplant the face, the medical team has to connect four jugular veins, extract bones and join all the musculature and blood vessels, according to El Pais.

"A face doesn't work if it cannot move," Barret was quoted as saying. 

A scar surrounds the patient's entire face, running along the roots of his hair, ears and under his chin, the newspaper said.