But suppose that when you looked in the mirror you saw only disfigurement – and suppose that this had kept you indoors for years, afraid to be stared at in the streets and commented upon by children. The thought of having a human face with which to greet the world, and to be normal again, even if it was not your own original one, would seem an immense blessing.Such a person should of course be welcomed into the community whatever they look like, because it is what is inside that truly matters; but it is easy to imagine them longing for a donor, and finding it very painful to hear people expressing their disgust at the idea of surgery that could literally help them face life. If the idea of facial transplant needed an advocate, it could well be any victim of Crouzon Syndrome, a genetic disorder which causes gross malformations of the cranium and facial structures. One sufferer described having hardly any facial bone, with no eye sockets, and her teeth in her sinus cavities She required two dozen operations to approach a normal look. Asked about a face transplant, she said she would not hesitate for a second to have one if she were starting over.Plastic surgeons perform wonders with skin and bone grafts when helping burn victims and those whose faces have been destroyed in accidents.

But the problem with grafted material is that it lacks mobility. A stiff mask of grafted tissue is fundamentally unsatisfactory. The medical techniques now available make it possible for surgeons to connect donor facial muscle and skin to the recipient's own nerve network and blood supply, thus restoring a working face with movement and expressiveness.Most of the medical advances that have surprised public opinion in recent years have prompted ethical debate: in vitro fertilisation, cloning, genetic therapies, and the like. So has the prospect of transplanting organs from animals to humans. But human-to-human transplantation, conducted under the proper safeguards, poses no such difficulty. Neither, in reality, and for the same reason, does face transplantation.

The problem is the unreflective belief that one IS one's face – that a face is somehow the essence of identity, and that to present oneself to the world by means of another person's face – another person's identity – somehow compromises one's own identity in the process.Such an attitude has to be overcome if people are going to agree to let the faces of their loved dead be used to help others.Whatever the doctors may be capable of, this instinctive but mistaken objection may prove to be the greatest barrier of all.A C Grayling teaches philosophy at Birkbeck College, University of London Questions of image 'My face isn't real. It is not the real me'Cindy Jackson has spent £60,000 on cosmetic surgery to alter her looks. Her writing about her experiences includes an autobiography, 'Living Doll'I'd be the first to donate my face. With all the money I've spent on my face it would be a waste to throw it away! I would not have problems receiving a face transplant – my face isn't real: it's not the real me anyway. It's no different from transplanting the heart or the eyes, which are quite personal things to give up.