Isabelle Dinoire, right, who on Nov. 27 received the world's first partial face transplant, and Dr. Sophie Testelin discuss the surgery in France.

Seven months after receiving the world's first partial face transplant, a French woman continues to improve, doctors said in the first detailed account of her surgery, published Monday with dramatic before-and-after pictures.

Isabelle Dinoire, 38, was severely disfigured in May 2005 by her Labrador retriever. She received the lips, nose and chin of a brain-dead woman in a 15-hour operation on Nov. 27 in northern France.

Doctors said the excellent cosmetic results have surprised not only the patient but also the medical community, and helped justify her doctors' decision to try the radical surgery.

"It is difficult to conceive that the same degree of success ... would have been possible with existing techniques" and no transplant, Dr. Patrick Warnke, a facial surgeon from the University of Kiel in Germany, wrote in a commentary published online by the Lancet, a British medical journal.

In the same journal, Dr. Bernard Devauchelle at Amiens University details how he and other surgeons kept the donor face on iced sponges during Dinoire's surgery as they carefully prepped it and the patient for the procedure.

During surgery, doctors discovered that the donated face lacked a key nerve that would have helped to animate the lower portion of Dinoire's face.

One week after the transplant, Dinoire could eat and chew, and her speech improved rapidly. Four months later, sensation had mostly returned, extending to the edge of one lip.

She experienced it once, with the new tissue turning beet red, like a mask. Big doses of immune-suppressing drugs brought it under control, but she must take such drugs lifelong.

The operation restored not only her appearance, but also her self-confidence, so that she's now willing to go out in public again, doctors said.

Since Dinoire's transplant, the Cleveland Clinic has inched forward with plans to do a full face transplant, Chinese doctors have done another partial face transplant, and a panel in England is considering a doctor's request to do one there.

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