The Yale Face Transplant Program focuses on reconstructive surgeries for patients who have a serious disfigurement or trauma to the face, head, and neck. This includes patients who have significant facial deformities they were born with, or those who have suffered devastating traumatic injuries, such as a burn, ballistic trauma, or an animal attack.
Facial reconstruction is a field that demands detailed planning and highly specialized surgical skills, as well as complex team logistics. We know that each person’s facial tissue is unique, so we reconstruct and restore the appearance and function of the face, and that includes its abilities for movement and sensation. Our goal is to restore appearance and function in a way that can impact both physical and mental health, and improve quality of life even in the most difficult situations.
Yale’s Face Transplant Program is led by a pioneer who performed the first three full-face transplants in the United States. Because face transplantation is a relatively new procedure, we are currently one of only a handful of programs in the U.S. that provides this type of surgery.
Facial transplantation surgery is, by necessity, multidisciplinary, involving collaboration among a variety of specialized surgeons and other providers. Each operation must be carefully orchestrated. Timing is critical, since transplant tissue must be procured from a donor who has died, and additional consent obtained from the family. And a successful transplantation requires a four-hour window from the time the facial tissue is detached from the donor to the time blood flow is re-established with the transplant recipient.
While each case is different—requiring its own unique approach—we perform facial transplantation conservatively, identifying and replacing only those areas of the face that are missing, if possible, and avoiding any part that is currently functioning.
Each operation takes at least 16 hours and typically more, usually with multiple microsurgical procedures to connect nerves and blood vessels. The use of computer 3-D simulation of the facial skeleton allows surgeons to design how the bone recovered from the donor will match the recipient, as much as possible. In addition to greater precision in planning of such a complex procedure, it also saves time during the surgery, which often translates into fewer complications. Face transplantation often results in the patient regaining normal functions—it involves opening the airway to restore smell and providing lips for better eating and speech.
These surgeries are major life events for patients, who already may have experienced a major trauma and lived with a difficult disfigurement while waiting for treatment to become available. We provide a variety of support, including psychiatric care, a social worker, and nursing coordinators who are ready to assist patients and families with whatever support they may need.
Our surgeries are carefully orchestrated endeavors that require the coordination of a truly multidisciplinary team. This includes not only plastic surgeons and ENT colleagues who specialize in the head and neck, but also anesthesiologists, critical care doctors and infectious diseases specialists. Perhaps the most critical collaborators are our transplant medicine physicians.
Education and support is available after surgery from a variety of providers to further restore function and optimize healing. Our team includes specialized nurses in the operating room, on the hospital floors, and in the intensive care units. We provide ongoing support from providers such as physical therapists, speech and swallow therapists, social workers, occupational therapists, and other specialist as patients recover from surgery.