Face Transplant
   HOME

TheInfoList



Click Here for Items Related To - Face Transplant
OR:
Face Transplant on:   [Wikipedia]   [Google]   [Amazon]

A face transplant is a medical procedure to replace all or part of a person's
face The face is the front of the head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may affect th ...
using tissue from a donor. Part of a field called "Vascularized Composite Tissue Allotransplantation" (VCA) it involves the transplantation of facial
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
, the nasal structure, the
nose A nose is a sensory organ and respiratory structure in vertebrates. It consists of a nasal cavity inside the head, and an external nose on the face. The external nose houses the nostrils, or nares, a pair of tubes providing airflow through the ...
, the
lip The lips are a horizontal pair of soft appendages attached to the jaws and are the most visible part of the mouth of many animals, including humans. Mammal lips are soft, movable and serve to facilitate the ingestion of food (e.g. sucklin ...
s, the
muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...
s of facial movement used for expression, the
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
s that provide sensation, and, potentially, the
bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
s that support the face. The recipient of a face transplant will take life-long medications to suppress the
immune system The immune system is a network of biological systems that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to bacteria, as well as Tumor immunology, cancer cells, Parasitic worm, parasitic ...
and fight off rejection. The world's first partial face transplant on a living human was carried out on Isabelle Dinoire, in Amiens (France), in 2005. The world's first full face transplant was completed in Spain in 2010. Turkey, France, the United States, and Spain (in order of total number of successful face transplants performed) are considered the leading countries in the research into the procedure. As of 2025, there have been around 50 face transplants. The ethics and benefits of face transplants are still being debated, and in 2019 a major UKRI grant was awarded to the historian Fay Bound Alberti to work with surgeons and patients and determine whether they are successful. Funded by the
UKRI UK Research and Innovation (UKRI) is a non-departmental public body of the Government of the United Kingdom that directs research and innovation funding, funded through the science budget of the Department for Science, Innovation and Technology. ...
th
Interface
project brought together surgeons from all around the world to determine what needed to be done to improve the procedure, and that work supported a more recent NASEM study to improve patient care and expectations. Thei
report
is now available online.


Beneficiaries of face transplant

People with faces disfigured by trauma,
burn A burn is an injury to skin, or other tissues, caused by heat, electricity, chemicals, friction, or ionizing radiation (such as sunburn, caused by ultraviolet radiation). Most burns are due to heat from hot fluids (called scalding), soli ...
s, disease, or
birth defect A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...
s might aesthetically benefit from the procedure. Professor Peter Butler at the
Royal Free Hospital The Royal Free Hospital (also known as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barnet Ho ...
first suggested this approach in treating people with facial disfigurement in a ''Lancet'' article in 2002, though it had been discussed for a decade in the USA. This suggestion caused considerable debate at the time concerning the ethics of this procedure. An alternative to a face transplant is facial reconstruction, which typically involves moving the patient's own skin from their back, buttocks, thighs, or chest to their face in a series of as many as 50 operations to regain even limited functionality, and a face that is often likened to a mask or a living
quilt A quilt is a multi-layered textile, traditionally composed of two or more layers of fabric or fiber. Commonly three layers are used with a filler material. These layers traditionally include a woven cloth top, a layer of padding, batting or w ...
.


History


Self as donor ("face replant")

The world's first full-face replant operation was on 9-year-old Sandeep Kaur, whose face was ripped off when her hair was caught in a thresher. Sandeep's mother witnessed the accident. Sandeep arrived at the hospital unconscious with her face in two pieces in a plastic bag. An article in ''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in Manchester in 1821 as ''The Manchester Guardian'' and changed its name in 1959, followed by a move to London. Along with its sister paper, ''The Guardian Weekly'', ''The Guardi ...
'' recounts: "In 1994, a nine-year-old child in northern India lost her face and scalp in a
threshing machine A threshing machine or a thresher is a piece of agricultural machinery, farm equipment that separates grain seed from the plant stem, stalks and husks. It does so by beating the plant to make the seeds fall out. Before such machines were developed ...
accident. Her parents raced to the hospital with her face in a plastic bag and a surgeon managed to reconnect the arteries and replant the skin." The operation was successful, although the child was left with some muscle damage as well as scarring around the perimeter where the facial skin was sutured back on. Sandeep's doctor was Abraham Thomas, one of India's top microsurgeons. In 2004, Sandeep was training to be a nurse. In 1996, a similar operation was performed in the Australian state of Victoria, when a woman's face and scalp, torn off in a similar accident, was packed in ice and successfully reattached.Seattle Times ''The Seattle Times'' is an American daily newspaper based in Seattle, Washington. Founded in 1891, ''The Seattle Times'' has the largest circulation of any newspaper in the state of Washington and the Pacific Northwest region. The Seattle Time ...
">


Partial face transplant


France

The world's first partial face transplant on a living human was carried out on 27 November 2005 by Bernard Devauchelle, an oral and maxillofacial surgeon, Benoit Lengelé, a Belgian plastic surgeon, and Jean-Michel Dubernard in
Amiens Amiens (English: or ; ; , or ) is a city and Communes of France, commune in northern France, located north of Paris and south-west of Lille. It is the capital of the Somme (department), Somme Departments of France, department in the region ...
, France. Isabelle Dinoire underwent surgery to replace her original face, which had been mauled by her dog. A triangle of face tissue from a brain-dead woman's nose and mouth was grafted onto the patient. On 13 December 2007, the first detailed report of the progress of this transplant after 18 months was released in the ''
New England Journal of Medicine ''The New England Journal of Medicine'' (''NEJM'') is a weekly medical journal published by the Massachusetts Medical Society. Founded in 1812, the journal is among the most prestigious peer-reviewed medical journals. Its 2023 impact factor was ...
'' and documents that the patient was happy with the results but also that the journey has been very difficult, especially with respect to her immune system's response. Dinoire died on 22 April 2016 at the age of 49 following cancer from medications. A 29-year-old French man underwent surgery in 2007. He had a facial tumor called a
neurofibroma A neurofibroma is a benign nerve-sheath tumor in the peripheral nervous system. In 90% of cases, they are found as stand-alone tumors (solitary neurofibroma, solitary nerve sheath tumor or sporadic neurofibroma), while the remainder are found in ...
caused by a genetic disorder. The tumor was so massive that the man could not eat or speak properly. In March 2008, the treatment of 30-year-old Pascal Coler of France, who has neurofibromatosis, ended after he received what his doctors call the world's first successful almost full face transplant. The operation, which lasted approximately 20 hours, was designed and performed by Laurent Lantieri and his team (Jean-Paul Meningaud, Antonios Paraskevas and Fabio Ingallina).


China

In April 2006, Guo Shuzhong at the Xijing military hospital in
Xi'an Xi'an is the list of capitals in China, capital of the Chinese province of Shaanxi. A sub-provincial city on the Guanzhong plain, the city is the third-most populous city in Western China after Chongqing and Chengdu, as well as the most populou ...
, transplanted the cheek, upper lip, and nose of Li Guoxing, who was mauled by an Asiatic black bear while protecting his sheep. On 21 December 2008, it was reported that Li had died in July in his home village in
Yunnan Yunnan; is an inland Provinces of China, province in Southwestern China. The province spans approximately and has a population of 47.2 million (as of 2020). The capital of the province is Kunming. The province borders the Chinese provinces ...
. Prior to his death, a documentary on the
Discovery Channel Discovery Channel, known as The Discovery Channel from 1985 to 1995, and often referred to as simply Discovery, is an American cable channel that is best known for its ongoing reality television shows and promotion of pseudoscience. It init ...
showed he had stopped taking immuno-suppressant drugs in favour of herbal medication; a decision that was likely a contributing factor to his death, according to his surgeon.


Turkey

Selahattin Özmen Selahattin Özmen is a Turkish plastic surgeon and a full professor of plastic surgery at the Koç University School of Medicine, department of plastic surgery and American Hospital Department of Plastic Surgery in İstanbul. he performed Turk ...
performed a partial face transplant on 17 March 2012 on Hatice Nergis, a twenty-year-old woman at
Gazi University Gazi University () is a Public university, public research university located primarily in Ankara, Turkey. It was founded in 1926 by Mustafa Kemal Atatürk originally as the Gazi Education Institute (Turkish language, Turkish: ''Gazi Eğitim Ens ...
's hospital in
Ankara Ankara is the capital city of Turkey and List of national capitals by area, the largest capital by area in the world. Located in the Central Anatolia Region, central part of Anatolia, the city has a population of 5,290,822 in its urban center ( ...
. It was Turkey's third, the first woman-to-woman and the first three-dimensional with bone tissue. The patient from
Kahramanmaraş Kahramanmaraş (), historically Marash (; ) and Germanicea (), is a city in the Mediterranean Region, Turkey, Mediterranean region of Turkey and the administrative centre of Kahramanmaraş Province, Kahramanmaraş province. After 1973, Maraş was ...
had lost her upper jaw six years prior in a firearm accident, including her mouth, lips, palate, teeth and nasal cavity, and was since then unable to eat. She had undergone around 35 reconstructive plastic surgery operations. The donor was a 28-year-old Turkish woman of Moldavian origin in
Istanbul Istanbul is the List of largest cities and towns in Turkey, largest city in Turkey, constituting the country's economic, cultural, and historical heart. With Demographics of Istanbul, a population over , it is home to 18% of the Demographics ...
, who had died by suicide. Nergis died in
Ankara Ankara is the capital city of Turkey and List of national capitals by area, the largest capital by area in the world. Located in the Central Anatolia Region, central part of Anatolia, the city has a population of 5,290,822 in its urban center ( ...
on 15 November 2016 after she was hospitalized two days prior complaining about acute pain.


Belgium

In December 2011, a 54-year-old man underwent a partial face transplant to the lower two-thirds of the face (including bone) after a ballistic accident. The operation was performed by a multidisciplinary team led by plastic surgeon Phillip Blondeel; Hubert Vermeersch, Nathalie Roche and Filip Stillaert were other members of the surgical team. For the first time 3D CT planning was used to plan the operation that lasted 20 hours. As of 2014 the patient is alive, with "good recovery of motor and sensory function and social reintegration".


Italy

In September 2018, a 49-year-old woman affected by Neurofibromatosis type I received a partial face transplant from a 21-year-old girl at Sant'Andrea Hospital of Sapienza University in Rome. The procedure took 27 hours and was carried out by two teams led by Fabio Santanelli di Pompeo and Benedetto Longo. The patient had a complication and after two days the surgeons had to replace the facial graft with autologous tissue. The patient is still alive and waiting for a second face transplantation.


Canada

In May 2018, the first Canadian complete face transplant was performed under the leadership of plastic surgeon Daniel Borsuk at the Hopital Maisonneuve Rosemont, in
Montreal Montreal is the List of towns in Quebec, largest city in the Provinces and territories of Canada, province of Quebec, the List of the largest municipalities in Canada by population, second-largest in Canada, and the List of North American cit ...
,
Quebec Quebec is Canada's List of Canadian provinces and territories by area, largest province by area. Located in Central Canada, the province shares borders with the provinces of Ontario to the west, Newfoundland and Labrador to the northeast, ...
. The transplant took over 30 hours and replaced the upper and lower jaws, nose, lips and teeth on Maurice Desjardins, a 64-year-old man that shot himself in a hunting accident. At that time, Mr. Desjardins was the oldest person to benefit from a face transplant.


Full face transplant

On 20 March 2010, a team of 30 Spanish doctors led by plastic surgeon Joan Pere Barret at the Vall d'Hebron University Hospital in
Barcelona Barcelona ( ; ; ) is a city on the northeastern coast of Spain. It is the capital and largest city of the autonomous community of Catalonia, as well as the second-most populous municipality of Spain. With a population of 1.6 million within c ...
carried out the world's first full face transplant, on a man injured in a shooting accident. On 8 July 2010, the French media reported that a full face transplant, including tear ducts and eyelids, was carried out at the Henri-Mondor hospital in
Créteil Créteil () is a Communes of France, commune in the southeastern suburbs of Paris, Île-de-France. It is located from the Kilometre Zero, centre of Paris. Créteil is the ''préfecture'' (capital) of the Val-de-Marne Departments of France, dep ...
. In March 2011, a surgical team, led by Bohdan Pomahač at
Brigham and Women's Hospital Brigham and Women's Hospital (BWH or The Brigham) is a teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two ...
in
Boston, Massachusetts Boston is the capital and most populous city in the Commonwealth (U.S. state), Commonwealth of Massachusetts in the United States. The city serves as the cultural and Financial centre, financial center of New England, a region of the Northeas ...
, performed a full face transplant on Dallas Wiens, who was badly disfigured in a power line accident that left him blind and without lips, nose or eyebrows. The patient's sight couldn't be recovered but he was able to talk on the phone and smell. In April 2011, less than one month after the hospital performed the first full face transplant in the country, the
Brigham and Women's Hospital Brigham and Women's Hospital (BWH or The Brigham) is a teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two ...
face transplant team, led by Bohdan Pomahač, performed the nation's second full face transplant on patient Mitch Hunter of Speedway, Indiana. It was the third face transplant procedure to be performed at BWH and the fourth face transplant in the country. The team of more than 30 physicians, nurses, anesthesiologists and residents worked for more than 14 hours to replace the full facial area of the patient, including the nose, muscles of facial animation and the nerves that power them and provide sensation. Hunter had a severe shock from a high voltage electrical wire following a car accident in 2001.


Poland

On 15 May 2013, at the Maria Skłodowska-Curie Institute of Oncology branch in
Gliwice Gliwice (; , ) is a city in Upper Silesia, in southern Poland. The city is located in the Silesian Highlands, on the Kłodnica river (a tributary of the Oder River, Oder). It lies approximately 25 km west from Katowice, the regional capital ...
, Poland, an entire face was transplanted onto a male patient, Grzegorz (aged 33) after he lost the front of his head in a machine accident at work. The surgery took 27 hours and was directed by Professor Adam Maciejewski. There had not been much planning or prep time before the surgery, which was performed about one month after the accident, because the transplantation was done as an urgent life-saving surgery due to the patient's difficulty in eating and breathing. Shortly after the donor's death, the decision to perform the surgery was made and his body was transported hundreds of kilometers to Gliwice once his relatives gave their consent. The doctors believe that their patient has an excellent chance to live a normal, active life after surgery, and that his face should operate more or less normally (his eyes survived the accident untouched). Seven months later, on 4 December, the same Polish medical team in Gliwice transplanted a face onto a 26-year-old female patient with
neurofibromatosis Neurofibromatosis (NF) refers to a group of three distinct genetic conditions in which tumors grow in the nervous system. The tumors are non-cancerous (benign) and often involve the skin or surrounding bone. Although symptoms are often mild, e ...
. Two months after the operation, she left the hospital.


Turkey

On 21 January 2012, Turkish surgeon Ömer Özkan and his team successfully performed a full face transplant at Akdeniz University's hospital in
Antalya Antalya is the fifth-most populous city in Turkey and the capital of Antalya Province. Recognized as the "capital of tourism" in Turkey and a pivotal part of the Turkish Riviera, Antalya sits on Anatolia's southwest coast, flanked by the Tau ...
. The 19-year-old patient, Uğur Acar, was badly burnt in a house fire when he was a baby. The donor was 39-year-old Ahmet Kaya, who died on 20 January. The Turkish doctors declared that his body had accepted the new tissue. Almost one month later on 24 February 2012, a surgical team led by Serdar Nasır conducted the country's second successful full face transplant at
Hacettepe University Hacettepe University () is a public research university in Ankara, Turkey. It was established on 8 July 1967. It is ranked first among the Turkish universities by University Ranking by Academic Performance in 2021. The university has two main c ...
's hospital in
Ankara Ankara is the capital city of Turkey and List of national capitals by area, the largest capital by area in the world. Located in the Central Anatolia Region, central part of Anatolia, the city has a population of 5,290,822 in its urban center ( ...
on 25-year-old Cengiz Gül. The patient's face was badly burned in a television tube implosion accident when he was two years old. The donor was a undisclosed 40-year-old (the donor's family did not permit the identity of the donor to be revealed), who experienced
brain death Brain death is the permanent, irreversible, and complete loss of Electroencephalography, brain function, which may include cessation of involuntary activity (e.g., Control of ventilation#Control of respiratory rhythm, breathing) necessary to su ...
two days before the surgery following a motorcycle accident that occurred on 17 February. On 16 May 2012, surgeon Ömer Özkan and his team at the Akdeniz University Hospital performed the country's fourth and their second full face transplant. The face and ears of 27-year-old patient Turan Çolak from
İzmir İzmir is the List of largest cities and towns in Turkey, third most populous city in Turkey, after Istanbul and Ankara. It is on the Aegean Sea, Aegean coast of Anatolia, and is the capital of İzmir Province. In 2024, the city of İzmir had ...
were burnt when he fell into an oven when he was three and half years old. The donor was Tevfik Yılmaz, a 19-year-old man from
Uşak Uşak () is a city in the interior part of the Aegean Region of Turkey. It is the seat of Uşak Province and Uşak District.Muğla Muğla () is a city in southwestern Turkey. The city is the center of the district of Menteşe, Muğla, Menteşe and Muğla Province, which stretches along Turkey's Aegean Sea, Aegean coast. Muğla's center is situated inland at an altitude of ...
. The receiver was 27-year-old patient Recep Sert from
Bursa Bursa () is a city in northwestern Turkey and the administrative center of Bursa Province. The fourth-most populous city in Turkey and second-most populous in the Marmara Region, Bursa is one of the industrial centers of the country. Most of ...
. On 23 August 2013, surgeon Ömer Özkan and his team at Akdeniz University performed the sixth face transplant surgery in Turkey. Salih Üstün (54) received the scalp, eyelids, jaw and maxilla, nose and the half tongue of 31-year-old Muhittin Turan, who was declared brain dead after a motorcycle accident that took place two days before. On 30 December 2013, Özkan and his team conducted their fifth and Turkey's seventh face transplant surgery at the hospital of Akdeniz University. The nose, upper lip, upper jaw and maxilla of brain dead Ali Emre Küçük, aged 34, were successfully transplanted to 22-year-old Recep Kaya, whose face was badly deformed in a shotgun accident. While Kaya was flown from
Kırklareli Kırklareli () is a city in the East Thrace, European part of Turkey. It is the seat of Kırklareli Province and Kırklareli District.Edirne Edirne (; ), historically known as Orestias, Adrianople, is a city in Turkey, in the northwestern part of the Edirne Province, province of Edirne in Eastern Thrace. Situated from the Greek and from the Bulgarian borders, Edirne was the second c ...
by an ambulance airplane. The surgery took 4 hours and 10 minutes.


United Kingdom

In October 2006, surgeon Peter Butler at London's
Royal Free Hospital The Royal Free Hospital (also known as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barnet Ho ...
in the UK was given permission by the
NHS The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
ethics board to carry out face transplants. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six-month intervals. As of 2022, neither Butler nor any other UK surgeon has performed a face transplant.


United States

In 2004, the
Cleveland Clinic Cleveland Clinic is an American Nonprofit organization, nonprofit Academic health science center, academic Medical centers in the United States, medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an O ...
became the first institution to approve this surgery and test it on cadavers. In 2005, the Cleveland Clinic became the first US hospital to approve the procedure. In December 2008, a team at the Cleveland Clinic, led by Maria Siemionow and including a group of supporting doctors and six plastic surgeons (Steven Bernard, Dr Mark Hendrickson, Robert Lohman, Dan Alam and Francis Papay) performed the first face transplant in the US on a woman named Connie Culp. It was the world's first near-total facial transplant and the fourth known facial transplant to have been successfully performed to date. This operation was the first facial transplant known to have included bones, along with muscle, skin, blood vessels, and nerves. The woman received a nose, most of the sinuses around the nose, the upper jaw, and even some teeth from a brain-dead donor. As doctors recovered the donor's facial tissue, they paid special attention to maintaining arteries, veins, and nerves, as well as soft tissue and bony structures. 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 in the 22-hour procedure. She had been disfigured to the point where she could not eat or breathe on her own as a result of a traumatic injury several years ago, which had left her without a nose, right eye and upper jaw. Doctors hoped the operation would allow her to regain her sense of smell and ability to smile, and said she had a "clear understanding" of the risks involved. Connie died 29 July 2020. The second partial face transplant in the US took place at
Brigham and Women's Hospital Brigham and Women's Hospital (BWH or The Brigham) is a teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two ...
in Boston on 9 April 2009. During a 17-hour operation, a surgical team led by Bohdan Pomahač, replaced the nose, upper lip, cheeks, and roof of the mouth – along with corresponding muscles, bones and nerves – of James Maki, age 59. Maki's face was severely injured after falling onto the electrified third rail at a Boston subway station in 2005. In May 2009, he made a public media appearance and declared he was happy with the result. This procedure was also shown in the eighth episode of the ABC documentary series Boston Med. The first full face transplant performed in the US was done on a construction worker named Dallas Wiens in March 2011. He was burned in an electrical accident in 2008. This operation, performed by Bohdan Pomahač and BWH plastic surgery team, was paid for with the help of the US defense department. They hope to learn from this procedure and use what they learn to help soldiers with facial injuries. One of the top benefits of the surgery was that Dallas has regained his sense of smell. The
Brigham and Women's Hospital Brigham and Women's Hospital (BWH or The Brigham) is a teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two ...
transplant team led by Bohdan Pomahač, performed the nation's second full face transplant on patient Mitch Hunter of Speedway, Indiana. Hunter, who is a US war veteran, was left disfigured in a car accident, burning about 94% of his face. It was the third face transplant procedure to be performed at BWH and the fourth face transplant in the country. The team of more than 30 physicians, nurses, anesthesiologists and residents worked for more than 14 hours to replace the full facial area of patient Mitch Hunter including the nose, eyelids, muscles of facial animation and the nerves that power them and provide sensation. Mitch Hunter was a passenger in a single cab pick-up truck, upon exiting the vehicle and pulling another passenger off a downed line, Hunter was then struck by a 10,000-volt 7-amp power line for a little under five minutes. The electricity entered his lower left leg, with the majority exiting his face, leaving him severely disfigured. He also lost part of his lower left leg, below the knee, and lost two digits on his right hand (pinkie and ring finger). Hunter has regained almost 100% of his normal sensation back in his face and his only complaint is that he looks too much like his older brother. 57-year-old Charla Nash, who was mauled by a chimpanzee named Travis in 2009, after the owner gave the chimp
Xanax Alprazolam, sold under the brand name Xanax among others, is a fast-acting, potent tranquilizer of moderate duration within the triazolobenzodiazepine group of chemicals called benzodiazepines. Alprazolam is most commonly prescribed in the ...
and wine. She underwent a 20-hour full face transplant in May 2011 at
Brigham and Women's Hospital Brigham and Women's Hospital (BWH or The Brigham) is a teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two ...
in
Boston Boston is the capital and most populous city in the Commonwealth (U.S. state), Commonwealth of Massachusetts in the United States. The city serves as the cultural and Financial centre, financial center of New England, a region of the Northeas ...
. Nash's full face transplant was the third surgery of its kind performed in the United States, all at the same hospital. In March 2012, a face transplant was completed at the University of Maryland Medical Center and R Adams Cowley Shock Trauma Center under the leadership of plastic surgeon Eduardo Rodriguez and his team (Amir Dorafshar, Michael Christy, Branko Bojovic and Daniel Borsuk). The recipient was 37-year-old Richard Norris, who had sustained a facial gunshot injury in 1997. This transplant included all facial and anterior neck skin, both jaws, and the tongue. In September 2014, another face transplant was performed by the Cleveland Clinic group. The patient had had complex trauma that masked the development of a rare type of autoimmune disease (granulomatosis with polyangiitis and pyoderma gengrenosum) affecting the face. It was the first face transplant in a patient with an autoimmune disease involving the craniofacial region. Prior to surgery, an analysis of renal transplant outcomes in granulomatosis with polyangiitis was conducted to evaluate allograft outcomes in these cohorts. That literature established feasibility and encouraged the Cleveland Clinic team to proceed with the surgery. The intervention was reported successful up to three years post-transplantation. In August 2015, a face transplant was completed at the NYU Langone Medical Center under the leadership of the chair of plastic surgery Eduardo D. Rodriguez and his team. A 41-year-old retired fireman named Patrick Hardison received the face of cyclist David Rodebaugh. In June 2016, a multidisciplinary team of surgeons, physicians and other health professionals completed a near-total face transplant at
Mayo Clinic Mayo Clinic () is a Nonprofit organization, private American Academic health science centre, academic Medical centers in the United States, medical center focused on integrated health care, healthcare, Mayo Clinic College of Medicine and Science ...
's Rochester campus. Patient Andrew Sandness, a 32-year-old from eastern Wyoming, had devastating facial injuries from a self-inflicted gunshot wound in 2006. The surgery, which spanned more than 50 hours, restored Sandness' nose, upper and lower jaw, palate, teeth, cheeks, facial muscles, oral mucosa, some of the salivary glands and the skin of his face (from below the eyelids to the neck and from ear to ear). The care team led by Samir Mardini, and Hatem Amer, the surgical director and medical director, respectively, for the Mayo Clinic Essam and Dalal Obaid Center for Reconstructive Transplant Surgery, devoted more than 50 Saturdays over years to rehearsing the surgery, using sets of cadaver heads to transplant the face of one to the other. They used 3-D imaging and virtual surgery to plot out the bony cuts so the donor's face would fit perfectly on the transplant recipient. Today, in addition to his physical transformation, Sandness can smell again, breathe normally and eat foods that were off-limits for a decade. In a 31-hour operation starting on 4 May 2017, surgeons at the Cleveland Clinic transplanted a face donated from Adrea Schneider, who had died of a drug overdose, to Katie Stubblefield, whose face had been disfigured in a suicide attempt by rifle on 25 March 2014. , Katie is the youngest person in the United States to have had a face transplant, age 21 at the time. Surgeons originally planned to leave her cheeks, eyebrows, eyelids, most of her forehead, and the sides of her face alone. However, because the donor face was larger and darker than Katie's, they made the decision to transplant the donor's full face. This holds the risk that in case of acute rejection in which the face must be removed, she would not have enough tissue for reconstructive surgery. Katie was featured on the cover of
National Geographic ''National Geographic'' (formerly ''The National Geographic Magazine'', sometimes branded as ''Nat Geo'') is an American monthly magazine published by National Geographic Partners. The magazine was founded in 1888 as a scholarly journal, nine ...
in September 2018 for an article entitled "The Story of a Face." In July 2019, 68-year-old Robert Chelsea became the oldest person, as well as the first black person in the world, to receive a full face transplant. On 6 August 2013, Robert was involved in an horrific car accident, leaving burns over 75% of his body. The severe damage meant that Robert was missing significant facial elements such as a part of his nose, which limited his ability to eat and drink. Functionality was important to Robert and was a key reason behind his pursuit of the surgery. In 2016, a face transplant was first discussed. Yet, health care disparities have led to a lack of black organ donations. This meant that Robert waited two years to find a face that matched something close to his own complexion. The surgery was performed on 27 July 2019 at Brigham and Women's Hospital. In February 2024, 30-year-old Derek Pfaff received a full-face transplant from an anonymous donor. Pfaff had previously shot himself in the face during a suicide attempt in March 2014, 10 years prior to the surgery. The results of the surgery were later revealed in November 2024.


Combined procedures

A number of combined VCA procedures, such as bilateral hand transplants, have been described in the literature and media sources. These combined procedures also include attempts at triple-limb and quadruple-limb transplants, however, only three face transplants have been attempted in combination with other allografts.


France

In 2009, Laurent Lantieri and his team attempted a face and bilateral hand transplant on a 37-year-old man who sustained extensive injuries during a self-immolation attempt one year prior. The patient ultimately died of anoxic brain injury two months after his initial transplant during surgical management of infectious and vascular complications. Autopsy revealed no signs of rejection in any of the allografts.


United States

On 12 August 2020, at NYU Langone Health in New York, New York, Eduardo D. Rodriguez led a team of over 140 personnel in successfully transplanting the face and bilateral hands of a brain dead donor onto 22-year-old Joe DiMeo, who sustained disfiguring burns after a car accident in 2018. The procedure lasted approximately 23 hours, and involved the entire facial soft tissue (extending from the anterior hairline to the neck, including the eyelids, nose, lips, and ears, along with strategic skeletal components), as well as both hands at the distal forearm level. Charla Nash's face transplant, described above, also initially included bilateral hands from the same donor. Circulation to Nash's transplanted hands was compromised after she was started on
vasopressors An antihypotensive, also known as a vasopressor, is an agent that raises blood pressure by constricting blood vessels, thereby increasing systemic vascular resistance. This is different from inotropes which increase the force of cardiac contra ...
as part of treatment for sepsis. The hands were ultimately amputated, however the patient survived, as did her facial allograft. In May 2023, a team of 140 doctors at NYU Langone Health successfully conducted the first combination eye transplant and partial face transplant. The patient, a 46-year-old linesman, was electrocuted by high voltage wires in 2021 causing the loss of the lower portion of his face and his left eye. The eye, while not restoring vision to the patient, has successfully received blood flow to the retina.


Ethics, surgery and post-operation treatment

The procedure consists of a series of operations requiring rotating teams of specialists. With issues of tissue type, age, sex, and skin color taken into consideration, the patient's face is removed and replaced (sometimes including the underlying fat, nerves, blood vessels, bones, and/or musculature). The surgery may last anywhere from 8 to 36 hours, followed by a 10- to 14-day hospital stay. There has been a substantial amount of ethical debate surrounding the operation and its performance. The main issue is that, as noted below, the procedure entails submitting otherwise physically healthy people to potentially fatal, lifelong immunosuppressant therapy. So far, four people have died of complications related to the procedure. Citing the comments of various plastic surgeons and medical professionals from France and Mexico, anthropologist Samuel Taylor-Alexander suggests that the operation has been infused with nationalist import, which is ultimately influencing the decision-making and ethical judgements of the involved parties. His most recent research suggests the face transplant community needs to do more in order to ensure that the experiential knowledge of face transplant recipients is included in the ongoing evaluation of the field. As of October 2019, th
AboutFace Project
, funded by
UKRI Future Leaders Fellowship
awarded to Dr Fay Bound Alberti, is exploring these debates as part of its wider research into the emotional and cultural history of face transplants. The AboutFace project has entered its second phase a
Interface
a research project which explores the relationship between identity, emotion, and communication, as revealed through the human face. After the procedure, a lifelong regimen of
immunosuppressive Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse react ...
drugs is necessary to suppress the patient's own
immune system The immune system is a network of biological systems that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to bacteria, as well as Tumor immunology, cancer cells, Parasitic worm, parasitic ...
s and prevent rejection. Long-term immunosuppression increases the risk of developing life-threatening infections, kidney damage, and cancer. The surgery may result in complications such as infections that could damage the transplanted face and require a second transplant or reconstruction with skin grafts.


References


Further reading

*


External links


Cleveland Clinic Face Transplant Video and Surgery Fact Sheet
{{Organ transplantation Tissue transplants Organ transplantation Plastic surgical procedures Oral and maxillofacial surgery French inventions