A team of surgeons at New York University’s Langone Medical Center has carried out the world’s most extensive face transplant, with the medical school’s dean Robert Grossman calling the operation “a major milestone and [a] critically important contribution to the advancement of science and medicine,” as reported by the Guardian.

A 41-year-old firefighter from Mississippi suffered dramatic and severe facial injuries when a collapsing, burning roof fell on him and melted through his mask back in 2001. Earlier this year, the man, called Patrick Hardison, was admitted to the New York medical center where he was to be given the face of a brain-dead man called David Rodebaugh, a 26-year-old Brooklynite who was left in a vegetative state after a major cycling accident.

The match was made based on compatible height, weight, skin tone, hair color, and blood type. The skin is an organ like any other, and each organ transplant has to consider the patient’s possible immune response to the new, foreign tissue entering their bodies. In many cases, the patient’s body outright rejects the organ, and the transplant procedure fails.

During the operation – which took 26 hours and involved more than 100 people working in two teams – Hardison’s scarred original face was cut away, before the new face was connected to his deeper facial structures through the attachment of many nerve endings, blood vessels, and bones; the new face’s skin was then “re-draped” over Hardison.

^{Image credit: The huge team that worked over 26 hours to perform the procedure. NYU Langone Medical Center.}

After the operation, he was started on a life-long course of immunosuppressant pills, which the doctors hoped would stop his body rejecting his new face. The wait to see if his body would accept the new skin was agonizing for lead surgeon Eduardo Rodriguez, who told Hardison that he had a 50 percent chance of surviving the operation.

“You have to remove the old face to the bare bones,” Rodriguez explained to Hardison, as reported by NYMAG. “You have to understand: If it were to fail, there is no bailout option. You would likely die. This is a procedure that is all or none.” At least three other patients around the world who have received facial transplants have died because the new skin was rejected by an overwhelming immune system response.

^{Image credit: Rodebaugh, the donor. NYU Langone Medical Center.}

However, 93 days after the procedure, Hardison is doing well, allowing the surgeons to declare the operation a success. In six months, Hardison should be able to eat normal food and will have drastically improved speech. In 2016, a follow-up operation will cut down some of the then-unnecessary facial tissue to improve its appearance.

In the months after the firefighting accident, Hardison could not look at himself in the mirror. Now, accompanied by some of the physicians that saw to him, he has been to Macy’s to buy clothes without that now-familiar social anxiety – an emotional experience for all involved.

^{Image credit: Hardison, pre-injury. NYU Langone Medical Center.}

Rodriguez added a final note of caution: “There will be a rejection [of the face] — not if but when,” as reported by NYMAG. When it does happen, doctors will treat it with more powerful immunosuppressants and hope for the best. In the meantime, Hardison can live a life as normal as possible, thanks to this pioneering procedure.

[H/T: The Guardian]