Facial transplantation: surgical techniques and results

ABSTRACT

Introduction. Severe facial trauma, burns, tumors, congenital and acquired malformations distort the shape of the face, which can be restored using facial transplantation methods. There are more than 20 facial transplant surgeries done in total. While facial reconstruction is technically complicated and a lengthy procedure, especially with patients who have severe facial deformities, often it is the only possible way of correction. Currently, various combinations of segments of the donor tissue or facial allograft are used for reconstructions. Improving operational equipment, perioperative care and immunosuppression prolongs the survival rate of the recipients and reduces rejection complications, as well as facilitates patients’ rehabilitation and reintegration into society.

Aim: To summarize the results of the World’s first facial transplant results, provided in the literature, paying attention to the applied surgical techniques, immunological treatment and aspects of aesthetics.

Objectives:               To compared the presented World’s first face transplant results in the literature and to analyze the surgical transplantation techniques applied, as well as immunological treatment and aspects of aesthetics.

Methodology: A research of articles in English language on the “PubMed” 2005 to 2013 database. Used keyword in the search: “facial transplant”, “facial reconstruction”, “full facial transplant”, “partial facial transplant”, “postoperative surveillance”, “transplant results”. Operation methodology results and comparisons are provided.

Results and conclusions.:  Facial transplantation allows one to restore the face of the functional and aesthetic integrity of patients with facial deformities that cannot be adjusted by conventional surgical methods. Good reconstruction results depend on the patient selection, surgical techniques, multidisciplinary team experience and immunological treatment. It is estimated that the total face allograft transplantation will be the preferred method of treatment of complex facial reconstructions. Long-term facial transplantation results are not described in the literature.