BACKGROUND: The central face high-energy avulsive injury has been frequently encountered and predictably managed at the R Adams Cowley Shock Trauma Center. However, despite significant surgical advances and multiple surgical procedures, the ultimate outcome continues to reveal an inanimate, insensate, and suboptimal aesthetic result. METHODS: To effectively address this challenging deformity, a comprehensive multidisciplinary approach was devised. The strategy involved the foundation of a basic science laboratory, the cultivation of a supportive institutional clinical environment, the innovative application of technologies, cadaveric simulations, a real-time clinical rehearsal, and an informed and willing recipient who had the characteristic deformity. RESULTS: After institutional review board and organ procurement organization approval, a total face, double jaw, and tongue transplantation was performed on a 37-year-old man with a central face high-energy avulsive ballistic injury. CONCLUSIONS: This facial transplant represents the most comprehensive transplant performed to date. Through a systematic approach and clinical adherence to fundamental principles of aesthetic surgery, craniofacial surgery, and microsurgery and the innovative application of technologies, restoration of human appearance and function for individuals with a devastating composite disfigurement is now a reality. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
BACKGROUND: The central face high-energy avulsive injury has been frequently encountered and predictably managed at the R Adams Cowley Shock Trauma Center. However, despite significant surgical advances and multiple surgical procedures, the ultimate outcome continues to reveal an inanimate, insensate, and suboptimal aesthetic result. METHODS: To effectively address this challenging deformity, a comprehensive multidisciplinary approach was devised. The strategy involved the foundation of a basic science laboratory, the cultivation of a supportive institutional clinical environment, the innovative application of technologies, cadaveric simulations, a real-time clinical rehearsal, and an informed and willing recipient who had the characteristic deformity. RESULTS: After institutional review board and organ procurement organization approval, a total face, double jaw, and tongue transplantation was performed on a 37-year-old man with a central face high-energy avulsive ballistic injury. CONCLUSIONS: This facial transplant represents the most comprehensive transplant performed to date. Through a systematic approach and clinical adherence to fundamental principles of aesthetic surgery, craniofacial surgery, and microsurgery and the innovative application of technologies, restoration of human appearance and function for individuals with a devastating composite disfigurement is now a reality. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
Authors: Ryan J Murphy; Chad R Gordon; Ehsan Basafa; Peter Liacouras; Gerald T Grant; Mehran Armand Journal: Int J Comput Assist Radiol Surg Date: 2014-09-18 Impact factor: 2.924
Authors: Jeff Chang; Scott S Graves; Tiffany Butts-Miwongtum; George E Sale; Rainer Storb; David Woodbridge Mathes Journal: Transplantation Date: 2016-12 Impact factor: 4.939
Authors: Ethan L Nyberg; Ashley L Farris; Ben P Hung; Miguel Dias; Juan R Garcia; Amir H Dorafshar; Warren L Grayson Journal: Ann Biomed Eng Date: 2016-06-13 Impact factor: 3.934
Authors: Gerald T Grant; Peter Liacouras; Gabriel F Santiago; Juan R Garcia; Mohammed Al Rakan; Ryan Murphy; Mehran Armand; Chad R Gordon Journal: Ann Plast Surg Date: 2014 Impact factor: 1.539
Authors: Joseph S Wallins; Akash A Chandawarkar; Allison Dobry; J Rodrigo Diaz-Siso; Ericka M Bueno; Edward J Caterson; Camille Jania; Nathanael D Hevelone; Stuart R Lipsitz; Srinivasan Mukundan; Bohdan Pomahac Journal: Plast Reconstr Surg Glob Open Date: 2015-06-05