The operation took place “several weeks ago”, but was kept quiet in order to monitor the results before making an announcement. The identity of the patient is not being released, nor is the specific trauma that caused the facial disfigurement.

“We can consider it a success,” Blondeel said at a recent press conference. Three days after the operation, the patient wrote “congratulations” on a note for Dr Blondeel, and six days later he was able to speak his first words and take a few sips of water. “That was a very special moment. This is someone who couldn’t previously breathe independently as a result of a severe trauma, let alone speak or drink.”

It is the 19th time a face transplant has been carried out in the world, following the first partial transplant in Amiens, France, in 2005 and the first full transplant in Spain in 2010. After France and Spain, Belgium now becomes the third country in which surgeons are able to offer the procedure.

The operation was first and foremost a massive task of organisation. From the moment a donor became available, it took 11 hours to go through the protocols and another nine before the two operations could start: one on the donor to remove the tissue, the other on the recipient. At hour 20, the team in the donor’s hospital began, while the Ghent team stood ready to begin transplanting. The second operation finished 10 hours later.

Prior to that, the team had undergone three years of preparation involving 65 specialists from 29 disciplines: not only surgeons but also radiographers, psychologists and specialists in prosthetics, anaesthetics and rehabilitation.

The operation concerned mainly the middle and lower parts of the face. The surgeons had to first remove the vestiges of previous attempts at reconstructive surgery, including plates and screws in places where the trauma had resulted in the loss of bone tissue. For both donor and recipient, exact 3D measurements had been made using a CT scanner, so the pieces fit together like a puzzle.

While the recipient was having a new face constructed, the same was happening to the donor. Out of respect for the deceased and his family, a team specialised in the manufacture and fitting of soft tissue prostheses made a mask to replace those parts that had been removed.

The operation involved not only skin and muscle but also bone and is one of the most complex of any of the face transplants carried out so far. “This breakthrough is unbelievably important,” Blondeel said. “We look on this not as a prestige project, but as a breakthrough in giving people back their lives. Until now, patients have had to make do with classic reconstruction techniques, and, after 15 or 20 difficult operations, the results were still disappointing. Now, with one operation, albeit a marathon one, all of the facial functions can be restored with very promising results.”