Learn about this complex surgery that uses donor tissue to replace all or part of a person's face.
A face transplant may be a treatment option for some people with severe damage to their faces or a visible difference in the appearance of their faces. A face transplant replaces all or part of the face with donor tissue from someone who has died.
A face transplant is a complex operation that takes months of planning and multiple surgical teams. The procedure is performed in only a few transplant centers worldwide. Each face transplant candidate is carefully evaluated to help ensure the best possible results in appearance and function.
A face transplant may enhance your life, but it is a high-risk procedure. You and your transplant team can't predict exactly how you will look and how your immune system will respond to the new face. You'll need to take special medications (immunosuppressants) for the rest of your life to reduce the risk of your body rejecting the transplanted face.
A face transplant is performed to try to improve the quality of life for someone who has experienced severe trauma, burns, disease or birth defects that affected his or her face. It is intended to enhance both appearance and functional abilities, such as chewing, swallowing, talking and breathing through the nose. Some people seek this surgery to reduce the social isolation they experience while living with visible differences in their faces.
A face transplant is a challenging procedure. It's fairly new and very complex. Since the first face transplant in 2005, more than 40 people are known to have undergone the surgery, ranging in age from 19 to 60. Several have died because of an infection or rejection.
Complications can result from:
Further surgeries or hospital visits may be needed to treat complications.
A face transplant is a complicated and lengthy procedure. You could be in surgery for 10 or more hours. Surgical and post-surgical risks can be life-threatening. They include blood loss, blood clots and infection.
Your body's immune system may reject the new face and other donor tissues. You could lose part or all of your new face and some function.
You may experience more than one episode of rejection. To control a rejection response, you may need to go to the hospital for an intensive IV dose of anti-rejection drugs. Your health care practitioner may switch the type of anti-rejection drugs you take. Rarely, tissue rejection requires a new transplantation. Rejection that isn't controlled could cause death.
You'll need to learn the symptoms of rejection so that you can take timely and appropriate action. They include swelling and a change in the color of your skin.
The anti-rejection drugs (immunosuppressants) you'll need to take daily for the rest of your life will weaken your immune system. This helps prevent tissue rejection, but it also puts you at risk of a variety of infections. Immunosuppressant drugs are also linked to an increased risk of kidney damage, cancer, diabetes and other serious conditions.
Before you receive a face transplant, reflect on these questions:
You'll be evaluated by a transplant team. Candidates must:
Once you're approved for a face transplant, you'll be placed on a waiting list for a donor face. When matching you with a donor face for a transplant, surgeons consider:
Your wait time can be unpredictable because it's usually not known when a donor face that matches your needs will become available.
In the meantime, you can prepare by:
The extent and length of your surgery depends on how much of the face and its underlying structures are involved. Your surgical team may transplant various tissues from the donor, such as skin, fat, muscles, tendons, cartilage, bone, nerves and blood vessels.
The transplant will take 10 to 30 hours. Your surgical team will include plastic surgeons highly skilled in microsurgery and craniofacial surgery, anesthesiologists, ophthalmologists, surgical nurses, surgical technicians, imaging experts, and others.
After surgery, you'll likely spend 4 to 8 weeks in the hospital. During this time, you will:
Your transplant team — including physicians, a transplant coordinator, social worker, therapist, pharmacists, dietitians and others — will work with you to develop a post-surgery treatment plan and provide the care you need.
Your daily post-surgical routine will include taking immunosuppressant medications and managing the side effects. These drugs can help stop your immune system from rejecting the donor face.
You can decrease the risk of rejection and medication side effects by:
You and your transplant team can't know for sure what the results of your surgery will be. Each previous face transplant recipient has had different experiences with the post-surgical appearance and function.
Most face transplant recipients experienced improved ability to smell, eat, drink, talk, smile and make other facial expressions. Some regained the ability to feel a light touch on the face. Because this surgical technique is still fairly new, the long-term results for face transplant recipients are yet to be determined.
Your results will be affected by:
You will increase your chance of a positive outcome by carefully following your post-transplant care plan and seeking the support of friends, family and your transplant team.