The UK Face Transplantation team at the Royal Free Hospital in London received permission for four transplants from the hospital's Research Ethics Committee on Wednesday.

Peter Butler, the plastic and reconstruction surgeon who will head the team, said: "We can now begin to evaluate patients and draw up a shortlist of four people who want to undergo this procedure."

People whose faces have been destroyed by fire, accident and infection could be among those to benefit.

Surgeons in France performed the first partial transplant in a 15-hour operation last year on Isabelle Dinoire who received a new nose, lips and chin after being mauled by her dog.

Researched decision

Butler said his team have developed psychological and surgical selection criteria to make sure they select the right patients for the surgery.

He said in a statement: "We will continue to take a cautious and careful approach and we will not be rushed. It may be many months before we are ready to carry out an operation."

The ethics committee said it reached its decision after reviewing a decade of research results by Butler and his team.

Andrew Way, chief executive of the hospital, said: "Ground-breaking research is always difficult and there will always be doubters and detractors.

"Face transplantation has been shown to be a successful treatment elsewhere and our team will now be able to begin the latest and most difficult phase of their work."

"Ground-breaking research is always difficult and there will always be doubters and detractors"

Andrew Wray, chief executive, Royal Free Hospital

The pioneering surgery on Dinoire by Professor Bernard Devauchelle and his team at the Centre Hospitalier Universitaire Amiens in northern France sparked an ethical debate and raised questions about the psychological impact of the procedure on both the recipient and the donor's family.

'Holy grail'

Although the microsurgery techniques needed for a full transplant are well established, little is known about the psychological impact and the long-term risk of the drugs the patient will take to avoid rejection of the new face.

Changing Faces, a charity that represents people with disfigurements, said it would have preferred the decision to have been delayed until the Royal College of Surgeons updated their recommendations on face transplants.

The charity said in a statement: "Our main concern is to ensure that any patient who is being considered for this procedure has a full understanding of the risks and benefits, especially the risks associated with the immunosuppressant drug regime."

Other experts welcomed the decision with Chris Cady of the British Association of Plastic, Reconstructive and Aesthetic Surgeons describing the procedure as a "holy grail".

The Face Trust, a charity which has been set up to fund research for surgical reconstruction and facial transplantation, launched an appeal for money to fund the transplants, which are expected to cost at least $46,940 each.