Facial transplantation is an incredibly rare procedure of removing part or all of a donor’s face and attaching it onto a patient who has suffered facial injury or deformity.
Doctors in the US have successfully completed a near-total face transplant on a 32-year-old man during an extensive, life-changing surgery to improve his ability to chew, speak, breathe and smell.
The face of recipient Andrew Sandness was destroyed by a gunshot wound after his attempt on his life in 2006. Mr. Sandness had no nose or jaw. His mouth was shattered; just two teeth remained. He'd lost some vision in his left eye.
His donor, Mr. Calen Ross, had also made a fatal attempt on his life in June 2016.
There was a match, and in the same month, Andy Sandness was admitted into the Mayo Clinic in Rochester, Minnesota for the procedure.
Dr. Samir Mardini, a specialist in facial reconstruction, spent over three years practicing the surgery and transplanting the faces of cadaver heads with his team. He had also been Mr. Sandness’s doctor for 10 years.
In total, the procedure required the combined effort of 9 surgeons and 40 operation staff. It took about 24 hours to procure the donor's face, which involved taking bone, muscle, skin and nerves. Then the recipient’s face was rebuilt below his eyes, taking an additional 32 hours.
It involved restoring Sandness’ nose, upper and lower jaw, palate, teeth, cheeks, facial muscles, and oral mucosa, some of the salivary glands and the skin of the face. The delicate and complex procedure included identifying nerve branches on the faces of both men and using electric currents to determine their function.
3D printed models and surgical guides played a major role in making this surgery possible, with 3D render highlighting all the parts that required reconstruction.
The facial nerves on both the donor and the patient had to be accurately mapped to ensure that Mr. Sandness would be able to move his face in a naturalistic manner after the operation.
In January 2017, a second procedure was performed to refine the features and promote the development of nerve cells in the face. Sandness has since made a full recovery.