According to the British daily, Peter Butler, a plastic surgeon at the Royal Free hospital in north London, has been given the go-ahead by a hospital ethics committee to find a patient who meets selection criteria.

The approval follows the world's first partial face transplant in France last month of Isabelle Dinoire, 38, who had been mauled by her dog.

The Guardian reported that Butler - who heads a 30-strong medical team - had been researching the process for 10 years, and that any selected patient was likely to have severe facial burns or facial trauma, and to have already had skin grafts.

Selection

"Quite a lot of issues around patient selection are not only physical but psychological," Butler said.

 "The main concern is that we choose the right patients. We'll be looking at how well they coped with their original disfigurement and how they coped with their surgery afterwards"

Peter Butler,
Plastic surgeon at London's Royal Free hospital

"The main concern is that we choose the right patients. We'll be looking at how well they coped with their original disfigurement and how they coped with their surgery afterwards. You need a psychological robustness to be able to deal with this."

Another important concern was that the donor's face could be easily recognisable on the person who received it and thus cause some distress to family and friends, but Butler said that computer simulations had proved that donor families would not recognise the face on the recipient.

Opposition

However, resistance to such a controversial operation is expected to come from the Royal College of Surgeons, who stated in 2003 that much more work was needed to be carried out, and was "unwise" to proceed.

Daniel Sokol, a medical ethicist at Imperial College, London, said: "With a full face transplant, the issue is how [people] cope with having a whole new face. It's like no other transplant because it deals with such an expressive part of who we are."

Butler's team members say they are optimistic that they will find a suitable patient and will then seek final approval - this time to perform the operation - from the hospital ethics committee.

Each operation will cost around £20,000 and private and charitable donations to fund the first five patents were being sought.