Face Transplant Procedure (In Depth)

Before Face Transplant:

Face transplant candidates go through an extensive screening process that is likely to last several months. This screening includes a psychiatric and social support evaluation and a series of imaging tests to help determine a patient’s physical and mental readiness for the procedure.

If it is determined that a patient is a suitable candidate,the patient will be placed on a transplant waiting list.Then they begin working with the New England Organ Bank team to find a donor who matches the recipient’s tissue requirements (similar age, right blood type). This search could take many months, and, if a suitable donor is not found within one year, they speak with the patient to determine whether they’re willing to continue waiting. 

When a donor is found, the patient is immediately informed about when to arrive at the hospital for the operation. As the timing for this type of procedure is extremely important, patients are expected to be readily available.

During Face Transplant:

The area most likely to be reconstructed in a partial face transplant is the central region of the face, which includes the nose and lips, since these facial structures are the most difficult to reconstruct with plastic surgery techniques.  One surgical team works on removing the facial graft from the donor as another team simultaneously prepares the facial defect on the recipient. Surgeons then connect the facial graft blood vessels to the patient's blood vessels under a microscope to restore blood circulation before connecting nerves and other tissue, such as bone, cartilage and muscles.  

While the face transplant is taking place, a separate, smaller surgery will also be performed.A skin sample (graft) is taken from the arm of the donor and then attached to the patient’s chest or abdomen. The intent is to have the graft behave like the face transplant tissue, eventually becoming part of the patient’s own skin. This is done so that later they can take the tiny samples (biopsies) of the new chest/abdomen tissue to look for signs of rejection, minimizing the need to disturb your new face tissue after surgery.

After Face Transplant:

Immediately after the surgery, the face transplant recipient will be taken to the Intensive Care Unit (ICU) for observation. The patient will typically stay in the ICU for one or two days and then be moved to a private room. At this point, a physical therapist will help the patient regain as much facial movement as possible, and a psychiatrist will discuss any psychological concerns. 

The patient will stay in the hospital until both the plastic surgery and medical transplant teams agree that it is safe for the patient to return home. This post-operative stay is anticipated to be approximately 7-14 days, but can vary due to many factors.