From Hollywood Fantasy to the Medical Fast Track

(Dec. 21) -- The Department of Defense has announced plans to fast-track face transplant surgery, with a $3.4 million grant for surgeons at the Brigham and Women's Hospital in Boston. An estimated 200 veterans of Iraq and Afghanistan are candidates for the procedure; better body armor and trauma care mean more troops survive the frequent roadside-bomb attacks that are a grim fixture of modern war – but return permanently disfigured. The grant means that face transplants could move from obscure science to clinical medical practice within two years. Brigham surgeons hope to operate on six to nine patients within 18 months.

Worldwide, surgeons have so far only performed nine face transplants, but the idea – however counterfactual – has been circulating in Hollywood for decades. A look back at the surgery's transition from movie screen to mainstream:

1960 – "Eyes Without A Face": The cult horror flick, based on a French novel and rereleased stateside as "The Horror Chamber of Doctor Faustus," depicts the face transplant of a young beauty disfigured in a car accident. Some surgery scenes were so graphic that a handful of audience members fainted at the film's premiere.

1990s – The patient as donor: In 1994, Indian surgeons reattached the face of a 9-year-old girl after it was torn off in a farming accident. Three years later, Australian doctors performed a similar operation on a woman whose face was packed in a bag of ice and brought to the hospital.

1997 – "Face/Off": Even as medical innovation was catching up with screenwriters' imaginations, Hollywood was taking new scientific liberties in its depictions of facial transplants. In John Woo's blockbuster, the director one-ups "Eyes Without a Face": Not only do John Travolta's and Nicholas Cage's characters' surgeries imply complete transformation of underlying facial structure, but – realism be damned – the two swap mugs twice.

2005 – "Nip/Tuck": In an episode of the glossy FX cosmetic surgery drama, doctors transplant the face of a brain-dead patient onto her 14-year-old sister, who's been injured at a carnival. Melodrama aside, this time the entertainment business shed light on a very real risk of the procedures: The girl's body rejected the transplant, and it had to be removed.

2005 – Partial transplants: Soon after "Nip/Tuck" aired, surgeons in France performed the first successful transplant of a nose and mouth. The patient, Isabelle Dinoire, has been a success story, despite immune system complications. Chinese surgeons followed soon after, but their patient died after he replaced immunosuppressive drugs with herbal remedies.

2008 – First American surgery: Four years after they started face transplant trials on cadavers, doctors at the Cincinnati Institute perform the United States' first face transplant surgery. It was also the most complicated yet: 80 percent of the donor's face was grafted onto the recipient, including muscles, bone, upper lip and nose.

2009 – Facial transplants get fast-tracked: Brigham surgeons plan to start recruiting suitable candidates for the surgeries – which cost between $250,000 and $300,000 each – using a government registry of injured veterans. Also on the horizon: research into improving immunosuppressive drugs, which surgery patients currently take indefinitely.