The world's first full face transplant is to take place within months in London.

Consultant surgeon Peter Butler today got the go-ahead from an NHS ethics committee to perform the historic surgery at the Royal Free Hospital in Hampstead, north London.

He will lead three teams as they remove a brain-dead donor's whole face - including the skin, underlying fat and eight blood vessels. The face will then be reconnected to a severely scarred recipient in an operation of at least ten hours.

The procedure will be much more complex than the partial face transplant onto a French woman last year.

No patient has yet been selected for the London operation, although 34 from across the world have approached Dr Butler so far.

He wants more candidates to come forward now that permission has been granted. Eventually four will be chosen for a series of staged operations, which could happen within "a year".

The patients would all be terribly disfigured with scars over their whole face - even on their scalp and ears.

Likely to be victims of burns, traumatic accidents or serious skin diseases, they would have undergone as many as 50 operations. But plastic surgery would not be able to help them anymore.

"There are a quarter of a million people in the UK with severe facial disfigurement," Dr Butler wrote in a commentary in the Evening Standard. "They live almost a 'twilight' existence, hiding in the shadows and afraid to expose themselves to an unforgiving public scrutiny."

Andrew Way, the chief executive of the Royal Free, said the hospital's ethics committee scrutinised a decade of research by Mr Butler's team for months.

"Groundbreaking research is always difficult and there will always be doubters and detractors," Mr Way said.

"However, there are many people with severe injuries for whom current surgical methods are not adequate and who desperately need help."

There was concern that the transplant patient would look like the donor after the surgery. But computer modelling by Dr Butler showed the new face would appear different due to the recipient's face shape and bone structure.

The Royal Free ethics committee also looked at the safety of the surgery and how the patient would cope with the psychological impact.

Furthermore, they considered whether the patient would survive taking immunosuppressant drugs after the operation to stop their body from rejecting the new tissue.

Dr Butler said he was "delighted" with the permission to press ahead. "This is a very new and important way of helping people with terrible facial injuries.

"We can now begin to evaluate patients and draw up a shortlist of four people who want to undergo this procedure."

He added that the team "would not be rushed". In the US, surgeons at the Cleveland Clinic in Ohio are also seeking suitable patients for an operation there.

"It may be many months before we are ready to carry out an operation," Mr Butler said.

Last year the 38-year-old Isabelle Dinoire, of France, became the world's first person to have a partial face transplant. She had her nose, lips and chin replaced after being mauled by a dog.

Earlier this year, she said in a television interview she now had "a face like everybody else. I hope this operation will help other people too".

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