Face Transplantation: An Update for the United States Trauma System

Face transplantation has evolved over the last 12 years into a safe and feasible reconstructive solution, with good aesthetic and functional outcomes for patients with severe facial defects who are not amenable to reconstruction through conventional and autologous approaches. Among patients who underwent face transplantation to date, a significant proportion did so following trauma, mostly ballistic and thermal injuries. It is therefore important for trauma surgeons who deal with these injuries regularly to be familiar with the literature on face transplantation following traumatic injuries. In this study, we provide a focused review on this topic, with an emphasis on highlighting the limitations of conventional craniomaxillofacial reconstruction, while emphasizing data available on the risks, benefits, surgical indications, contraindications, as well as aesthetic and functional outcomes of face transplantation. The authors also provide an update on all face transplants performed to date including traumatic mechanisms of injury, and extent of defects. They finally describe 2 cases performed by the senior author for patients presenting with devastating facial ballistic and thermal injuries. The authors hope that this work serves as an update for the trauma surgery community regarding the current role and limitations of face transplantation as a craniomaxillofacial reconstructive option for their patient population. This can potentially expedite the reconstructive process for patients who may benefit from face transplantation. Address correspondence and reprint requests to Eduardo D. Rodriguez, MD, DDS, Chair, Hansjorg Wyss Department of Plastic Surgery, Helen L Kimmel Professor of Reconstructive Plastic Surgery, NYU Langone Medical Center, 307 East 33rd Street, New York, NY 10016; E-mail: eduardo.rodriguez@nyumc.org Received 6 March, 2018 Accepted 13 March, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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