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A woman who had suffered severe facial trauma received, essentially, a new face in an operation that goes further than any previous face transplant, hospital officials at the Cleveland Clinic disclosed yesterday.

Only the woman's upper eyelids, forehead, lower lip and chin were left - the remaining 80 per cent of her face was replaced with one donated from a female cadaver during 22 hours of surgery performed about two weeks ago at the clinic.

After the transplant, "I must tell you how happy she was when, with both her hands, she could go over her face and feel that she has a nose, feel that she has a jaw," said lead surgeon Maria Siemionow.

It was the first face transplant performed in the United States and the fourth worldwide, though the others were not as extensive as this one.

The patient's name and age were not released, nor details on how she was injured. The damage was so horrific that she lacked a nose and palate, and could not eat or breathe without a special opening into her windpipe.

"This patient exhausted all conventional means of reconstruction, and is the right patient," Dr. Siemionow told a news conference.

So many disfigured patients are stuck "in their houses ... hiding from society," she said. "Our patient was called names and was humiliated. You need a face to face the world."

The woman is doing well and showing no signs of rejecting the new face, doctors said.

It is the first facial transplant known to have included bones, along with muscle, skin, blood vessels and nerves. The woman received a nose, most of the sinuses around the nose, the upper jaw, and even some teeth, said Frank Papay, the clinic's plastic surgery chief.

The face was donated by a family that was asked specifically to approve the gift - not simply done under general organ donation consent rules, said officials of LifeBanc, the organ procurement group in northeast Ohio that arranged the transplant.

The recipient was not shown a picture of the donor, and in animal experiments "the recipient never looks like the donor," especially when the injuries are so severe, Dr. Siemionow said.

The hospital posted a statement from the woman's family on its website.

"We never thought for a moment that our sister would ever have a chance at a normal life again, after the trauma she endured," it says. "But thanks to the wonderful person that donated her organs to help another living human being, she has another chance to live a normal life. Our family cannot thank you enough."

Unlike operations involving vital organs such as hearts and livers, transplants of faces or hands are done to improve quality of life - not to extend it. Recipients run the risk of deadly complications and must take immune-suppressing drugs for the rest of their lives to prevent organ rejection, raising their odds of cancer and many other problems.

Dr. Siemionow considered dozens of potential candidates over the past four years, ever since the clinic's internal review board gave permission for her to attempt the operation.

"The surgery took 22 hours. The preparation to the surgery took over 20 years," she said.

The world's first partial face transplant was performed in France in 2005 on a 38-year-old woman who had been mauled by her dog. Isabelle Dinoire received a new nose, chin and lips from a brain-dead donor. She has done so astoundingly well that surgeons have become more comfortable with a radical operation considered unthinkable a decade ago.

Two others have received partial face transplants since then - a Chinese farmer attacked by a bear and a European man disfigured by a genetic condition.