The helsinki face transplantation: surgical aspects and one-year outcome

Publication date: Available online 15 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Patrik Lassus, Andrew Lindford, Jyrki Vuola, Leif Bäck, Sinikka Suominen, Karri Mesimäki, Tommy Wilkman, Tuija Ylä-Kotola, Erkki Tukiainen, Hannu Kuokkanen, Jyrki Törnwall
BackgroundSince 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and one year clinical outcome in Finland's first face transplant case.MethodsA 34 year-old male who had a severe facial deformity following ballistic trauma in 1999 underwent facial transplantation in the Helsinki University Hospital on 8^th February 2016. Three-dimensional (3D) technology was used to manufacture donor and recipient patient specific osteotomy guides and a donor face mask. The facial transplant consisted of a Le Fort II maxilla, central mandible, lower ⅔ of the midface muscles, facial and neck skin, oral mucosa, anterior tongue and floor of mouth muscles, facial nerve (3 bilateral branches), and bilateral hypoglossal and buccal nerves.ResultsAt one-year follow-up there have thus far been no clinical nor histological signs of rejection. The patient has a good aesthetic outcome with symmetrical restoration of the mobile central part of the face with recovery of pain and light touch sensation to almost the entire facial skin and intraoral mucosa. Electromyography at 1 year has confirmed symmetrical muscle activity in the floor of the mouth and facial musculature and the patient is able to produce spontaneous smile. Successful social and psychological outcome has also been observed. Postoperative complications requiring intervention included: early (nasopalatinal fistula, submandibular sialocele, temporomandibular joint pain, and transient type 2 diabetes) and late (intraoral wound and fungal infection, renal impairment, and hypertension).ConclusionAt one year we report overall good functional outcome in Finland's first face transplant.