Behind the scenes of the most extensive facial transplant to date

https://www.washingtonpost.com/national/health-science/behind-the-scenes-of-the-most-extensive-facial-transplant-to-date/2015/11/23/919d089e-8d65-11e5-acff-673ae92ddd2b_story.html

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Last week, NYU Langone Medical Center announced that its surgeons had performed the world’s most extensive facial transplant to date, including the entire scalp, ears and eyelids. At the same time, New York magazine published an in-depth account of the transplant, a compelling read that details the human lives involved, the tragedies that brought them together and the amazing — but far from perfect — reality of this profoundly transformative surgery.

Almost every aspect of Steve Fishman’s article is dramatic.

Volunteer firefighter Patrick Hardison was injured in 2001 trying to rescue a woman believed to be trapped inside a burning house; just about the time he staggered out with his face on fire, she came home — she’d been out fishing.

Eduardo Rodriguez, the son of Cuban immigrants, began as a dentist and became a confident, ambitious plastic surgeon who performed his first facial transplant at the University of Maryland Medical Center in 2012. There he met the severely deformed Hardison and promised: “We’re going to make you normal.” All they needed was a new face.

David Rodebaugh, a member of a tough bunch of Brooklyn cyclists called Lock Foot Posi, talked of having raced cars and jumped out of a helicopter; he died in August after a midnight accident in which his bike hit a pedestrian and he flew off and landed on his helmet-less head.

The story is not for the squeamish reader. This is how it begins:

For the moment, the face belongs to no one. It floats in a bowl of icy, hemodynamic preserving solution, paused midway on its journey from one operating room to another, from a 26-year-old Brooklyn bike mechanic who’d been declared brain-dead 48 hours earlier to a 41-year-old Mississippi fireman whose face had burned off in a blaze 14 years ago. . . . A surgeon reaches his gloved hands into the blood-tinged liquid and kneads the face, draining the last of the mechanic’s blood. Then he lifts the face up. . . . As he raises it, it seems to inflate and take the shape of a face again, one that no longer resembles the cyclist. The forehead is shorter, the cheeks puffier. The lips have fallen into a crescent, as if smiling. The face looks like it will when, an hour later, it is fitted over the raw skull of the fireman waiting in the next room.

There are photographs of Rodebaugh and of Hardison before and after his surgery (some may be hard to look at), a graphic illustrating how the surgery was performed and a moving video of Hardison speaking today.

He lives with pain and always will; and he knows that someday, despite daily immunosuppressant drugs, his body will reject the face. At that point, doctors will treat him with massive amounts of drugs and steroids and hope for the best.

Meanwhile, he has a face — a face that nobody stared at one day this fall when he walked into a Macy’s. When he told Rodriguez about that miraculous normalcy, Fishman writes, Hardison was in tears.