It was 20 years before Dr. Maria Siemionow could make the phone call to Dr. Frank Papay.

Finally late one night she called Dr. Papay, who is the chief of dermatology and plastic surgery at the Cleveland Clinic, and told him – “We have a Donor.”

She then travelled to the hospital and re-gave a woman her upper jaw, nose, cheeks and lower eyelids (80% of her face in all). The woman could not previously eat, talk, smile, smell or breather on her own.

In the conference on Wednesday, the doctors from the Cleveland Clinic performed the world’s most extensive face transplant in a 22-hour surgery that took place in the clinic sometime within the last two weeks. The team first had to select a donor that matched the patient’s blood type, race, gender, and approximate age, then it began.

The operation involved eight surgeons. The doctors paid special attention to maintaining arteries, veins, and nerves, as well as soft tissue and bony structures, as they recovered the brain-dead donor's facial tissue (including some of the teeth), this part of the operation took nine hours.

The surgeons then connected facial graft vessels to the patient's blood vessels in order to restore blood circulation in the reconstructed face before connecting arteries, veins and nerves, restoring blood circulation. The skin responded, and turned pink, showing that the graft worked.

The operation was a success, and the patient is doing well. It was the fourth such procedure to be done in the world, and the first in the United States.

The patient requested that the clinic do not release her name, age or any details about the cause of her disfigurement. The doctors could say however that it was severe.

Siemionow mentioned that Children were afraid of her, and she couldn’t even go out of her house.

The operation was prepared for by Siemionow for decades, as she practiced on animals and tested on cadavers. The Cleveland Clinic ethics board gave her permission in 2004 to perform this experimental transplant on human beings, so she formed her team.

A similar, but only partial transplant was performed in 2005 on a French woman who’d been mauled by a dog, followed by two more, with Siemionow’s being the fourth. As the surgery was experimental, it was paid for by the Cleveland Clinic, as will be follow-up care, according to a clinic spokesman. He gave no cost estimate.

As the patient awoke from the marathon surgery she touched her face, which was still swollen, and gave doctors a thumbs up, the physicians say.

Hopefully, given physical therapy, she will learn to smile, talk, blink again and breathe without the aid of a breathing tube. The downside is that she will have to take powerful immunosuppressant drugs for the rest of her life or have the transplant rejected by her own body.