By PETER ALLEN

Last updated at 18:38 01 October 2007

The world's first face transplant recipient has spoken of her horror at "living" with the features of a suicide victim.

Isabelle Dinoire, a 40-year-old divorcee from Valenciennes, northern France, underwent the groundbreaking operation almost two years ago.

Surgeons replaced the nose, lips and chin of Miss Dinoire with those of 47-year-old Maryline St Aubert, a schoolteacher who hanged herself in nearby Lille.

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Since then Miss Dinoire has learnt to eat again, to speak properly, and to pull a range of expressions which make her feel '"completely normal".

But in a revealing book in which she speaks of her new life, Miss Dinoire says she was initially filled with self-disgust.

"Having the inside of the mouth of someone else - it didn't belong to me. It was atrocious," said Miss Dinoire, a divorced mother-of-two.

"One day I said, 'My nose is itching'. I looked at my daughter and said: 'That's nonsense. It's not my nose. I have a nose that is itching'."

Miss Dinoire has also noticed that a hair had sprouted from her chin.

"I had never had one. You knew it's yours but at the same time 'she' is there. I am making her live, but that hair is hers," she says in Le baiser d'Isabelle (Isabelle's Kiss), a book by Noëlle Châtelet.

Kissing also remains beyond Miss Dinoire, with a doctor telling her: "If we do the operation like that, I guarantee that you will be able to eat.

"But the one thing which no-one is sure of is that if one day you will be able to kiss."

Although Miss Dinoire's mouth no longer hangs open, co-ordinating her face muscles into a kiss remains an extremely difficult gesture.

"I'm battling, I'm continuing to try and get there. When I hear people say I will never get there it gives me even more determined," she said.

Before her operation, Miss Dinoire divorced Vincent Guarendelli, the father of their girls, Lucie 18, and Laure, 14, who now live away from their mother.

Each week Miss Dinoire still has travel to Amiens where she undergoes a battery of tests, re-education sessions, and spends time with her dedicated psychologist, Sophie Crimades.

Miss Dinoire must also occasionally make the far longer journey to the southeastern city of Lyon - some 300 miles away - where she receives more complicated anti-rejection treatments.

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While the lifelong drug treatment is something she feels she can learn to accept, it is the persistent thought that her body could reject the skin graft which worries her most.

Miss Dinoire has to examine a small patch of skin on her stomach - known as a "sentinel" - a number of times a day to make sure there is nothing wrong.

If there is she can sound the alarm immediately. As early as December 2005 there was a terrifying scare when she appeared to be rejecting the new tissue, but a course of steroids averted the crisis.

Her powerful anti-rejection drugs will suppress her immune system for the rest of her life -- making her more vulnerable to infection, as well as serious diseases including cancer.

There is a 10 per cent chance of rejection in the first year, rising to 50 per cent in the next five to 10 years.

Britain's Royal College of Surgeons reported in 2003 that the psychological consequences of going through such a rejection would be "immense".

To reduce the chances of rejection further she will receive injections of bone marrow cells from Miss St Aubert's body.

In the past Miss Dinoire has frequently complained about feeling "under siege" from those interested in the operation, so the new book is something of a departure.

Miss Dinoire, who used to work selling knitting materials but was officially unemployed for around a year before her disfigurement, said: "I am recognised by almost everybody in the street nowadays. That is the main reason that I do not like going out alone.

"My ambition after the operation was to study accounting and to open a baby clothes shop. Getting a proper job may now be impossible."