Surgeons were yesterday urged not to compete in a "face race" for the first face transplant despite confidence that technical expertise was close to making the procedure possible.

Ethical, legal and moral issues as well as psychological consequences for patients and the families of donors needed far more investigation, as did the risks of the body rejecting skin, fat and muscle tissue, concluded a report from the Royal College of Surgeons.

The college president, Professor Sir Peter Morris, said: "We do not feel the time is appropriate to see this experimental procedure. The microsurgical skills and anatomical knowledge required to carry out facial transplantations are already well established.

"But facial transplantation is not only a matter of technical achievement. We must also take into consideration the psychological impact on the recipient and on the donor family, and the considerable long-term risks of the need for lifetime immunosuppression drugs."

Professor Len Doyal, of St Bartholomew's hospital and the Royal London School of Medicine and Dentistry, a member of the working group behind the report, warned against any international race to be the first to perform such a transplant. "Any idea people were moving ahead for national reasons would be extremely concerning."

Surgeons in the field agreed with the college's cautious approach. Peter Butler, of the Royal Free Hospital, London, called the subject "one of the most sensitive in medical science today.

"There are very serious ethical, psychological and moral questions to be resolved before face transplants can begin and we are determined that a sensible and responsible process will be put in place to do that, however long it takes."

The surgery, "if ever done" , would be complex, quite difficult, and lengthy.

He said, however, that "probably the Chinese could easily do it tomorrow. There is a guy in Colombia talking about it. This ought to be done in a slow, methodical process. If it is not done that way, it will be a disservice to medicine."

Mr Butler said he was looking at creating a charity to fund further work. It would not be right to use NHS cash on such an experimental technique.

John Barker, from Louisville University in the US, said: "We believe we are ready ... the right team could do this today."

But Dr Barker said the idea of a "race" had been created by the media. "If I were in a race, I think I should know about it. I don't know about it so we are not in a race."

The Royal College report suggests there might be a one in 10 chance of immediate acute rejection. Chronic rejection occurs in 30-50% of patients, with new faces gradually undermined by deteriorating tissue over two to five years.

Despite research on the body's tolerance of transplanted organs, it said there was little prospect this would happen outside the laboratory within the next five years.

Sir Peter called for more experiments on animals to assess the risks of rejection. "Remember a face transplant is being done to improve quality of life, not to save life."

The report has also raised questions over identity, the laws of consent to surgery, and whether patients would follow the strict regime of anti-rejection drugs, staying out of the sun and changes in diet.

Experience of other transplants suggested they were at far greater risk of cancers and hypertension. The report said: "Facial transplantation would constitute a major breakthrough in restoration of a quality of life to those whose faces have been destroyed by accident or tumour.

The Changing Faces charity, which had asked the college to investigate the issues, welcomed the report, saying it recommended a much more incremental approach.