Face-transplant breakthroughs - Incredible images from a decade saving face

Doctors explain the procedure on Patrick Hardison at a news conference in New York © Mike Segar
A Tennessee firefighter whose face was destroyed in a 2001 house fire has received the world's most extensive face transplant. 41-year-old Patrick Hardison received the face of 26-year-old David Rodebaugh in a grueling 26-hour surgery.

When Hardison was 26, he was a volunteer fireman in Senatobia, 40 miles south of Memphis, when he went out on a call for a house fire. There was a woman trapped inside the burning home. Hardison raced inside, hoping to save her.

Moments later, the roof collapsed on him, knocking his helmet off and melting his mask. Hardison lost his eyelids, ears, lips and most of his nose in the fire. His hair burned off as well.

Dr. Eduardo D. Rodriguez shows a picture of transplant patient Patrick Hardison © Mike Segar

"From that day on ‒ September 5, 2001 ‒ there was no normal tissue left throughout his face," Eduardo D. Rodriguez, chair of plastic surgery at NYU Langone Medical Center, told reporters.

Hardison went through a grueling 70 surgeries and multiple skin grafts, but still had "no semblance of normal anatomy," Rodriguez said. The former firefighter felt tremendous pain when trying to do everyday activities like talking or eating.

Rodebaugh, a BMX cyclist from Ohio, died in July 2015. He was an organ donor. On August 14, Rodriguez and his team began the facial transplant. The operation, which the hospital estimates cost between $850,000 and $1 million, was funded by a grant from NYU Langone.

The first face transplant surgery was performed ten years ago this month. We took a look at the extraordinary images of this complex, cutting-edge practice.

Partial transplants

Isabelle Dinoire speaks for the first time after receiving a partial-face transplant © Pascal Rossignol

The first attempt at the procedure was in France ‒ a partial transplant on 38-year-old Isabelle Dinoire. She had been mauled by her dog, who was trying to wake her after an overdose of sleeping medication. Dinoire lost her nose, lips, chin and parts of her cheeks.

Doctors spent 15 hours transferring skin, muscles, bones and blood vessels from a brain-dead suicide victim to Dinoire. The operation was a success but doctors advised her that her body could still decide to reject the face at any time.

Dinoire and all subsequent face transplant patients are required to take anti-rejection medication for the rest of their lives.

A doctor inspects Li Guoxing after the surgery © STR

In 2006 Li Guoxing underwent a similar partial transplant in China. He died two years later amid reports that he had stopped taking his anti-rejection medicine in favor of herbal remedies.

Connie Culp before and after her face-transplant © Cleveland Clinic

Connie Culp was the first person to receive a face -transplant in the US, in 2008. She required the surgery after her husband shot her in the face before killing himself. Her nose, cheeks, mouth and an eye were destroyed. She was also unable to breathe without assistance.

Culp underwent a successful 22-hour surgery and now works as an advocate for organ donation.

Charla Nash was not so fortunate, losing her hands and face when her neighbor's 200-pound chimpanzee attacked her in Connecticut. Charla initially went through a successful transplant of both face and hands, but the hands had to be removed shortly afterwards, as they failed to work with her body.

Full transplants

 The 31-year-old identified as Oscar speaks at a press conference following his surgery © Marti Fradera

In 2010, doctors in Barcelona performed the first full face transplant on a farmer known only as Oscar, who had accidentally shot himself in the face. An entire face – including jaw, nose, cheekbones, muscle, teeth and eyelids – was placed onto Oscar's skull like a mask.

One week after the operation, the 31-year-old had to be shaved because he was growing a beard. Doctors noted this as a sign the operation was successful.

Dallas Wiens after the surgery © Brian Snyder

The US was soon to follow, with a full transplant in March 2011 for Dallas Wiens, a painter whose face was burned off by a high-voltage wire. Although  Wiens' sight could not be restored, doctors at Brigham and Women's Hospital in Boston, Massachusetts did manage to restore his sense of smell.

The  surgery was paid for by the US military as part of an initiative to learn how to help soldiers with severe facial wounds.

Richard Norris before his face transplant surgery © University of Maryland Medical Center

Another full transplant in the US went to Richard Norris, in 2012. Norris lost his nose, lips and mouth movement in a 1997 gun accident.

Norris lived as a recluse for 15 years after the accident and said the operation had given him his life back.

His surgery was also funded by a grant from the US military, which estimates that over 200 soldiers may be eligible for face transplants.

Richard Norris after his face transplant surgery © University of Maryland Medical Center

Face transplants are still a new and complex medical procedure, with a 50/50 chance of success at best.

The surgery also carries a massive risk, noted Dr. Rodriguez from the NYU Langone Medical Center. Of the estimated 20 partial and full face transplants since 2005, between three and five patients have died after new tissue was rejected.