A former firefighter from Tennessee received the face of a brain-dead man from Brooklyn through the “most extensive” facial transplant ever performed.

Dr. Eduardo Rodriguez, a plastic surgeon at the Langone Medical Center in New York University, performed the operation that took more than 26 hours back in August. The facial transplant surgery gave 41-year-old Patrick Hardison the face of 26-year-old David Rodebaugh, a bike mechanic who figured in a cycling accident in July and fell into a coma days later. Rodebaugh was declared brain-dead on Aug. 12.

A house fire in Senatobia, Mississippi on Sept. 5, 2001 caused Hardison’s extreme burns and caused flesh from his thighs to be transplanted to his face. He had undergone 71 procedures at seven operations a year, and had become dependent on pain medication.

“Kids ran screaming and crying when they saw me,” Hardison said in a comprehensive magazine interview. “There are things worse than dying.”

 The Surgery

Rodebaugh’s face was not the first offered to Hardison. The first was from a Hispanic man, but the man's family withdrew consent. The second, from a woman, was declined by Hardison. He was then offered Rodebaugh’s face through NY-based organ donor network LiveOnNY.

Rodriguez and Hardison met in 2012. Rodriguez warned his patient that the surgery would be “the most extensive face transplant yet performed” and had only a 50 percent chance of success.

The surgery was held on Aug. 14 this year, two days after Rodebaugh's brain death. Here is a look at the process:

1. Over the course of 12 hours, Rodebaugh’s face was detached from the body intact.
2. In a separate operating room, Hardison’s scarred facial tissue was removed.
3. Rodebaugh’s face was transferred in hemodynamic preserving solution.
4. Rodebaugh’s face was attached at the chin, cheekbones and nose using screws. Certain nerves were linked while others would regenerate
5. Once the major veins were connected, Hardison’s new face swelled by 50 percent, but the swelling subsided gradually.

There were a number of issues during the procedure, such as Hardison’s jugular vein being bigger than Rodebaugh's, causing dangerous blood loss. To improvise, the surgeon inserted one jugular into a tiny cut hole in the side of the other.

 Facial Transplants In The Past

While uncommon, facial transplants had been done in the past decade. A partial facial transplant was done in 2006 on 38-year-old Isabelle Dinoire, a French woman who suffered from a dog bite. In the United States, the first one was done in 2008 on 46-year-old Connie Culp from Cleveland who had been shot by her own husband in 2004.

In 2010 in Spain, the world’s first full facial transplant surgery was performed on a 31-year-old farmer who accidentally shot himself in the face.

Expectations

Hardison is currently recovering and is expected to take immunosuppressants for the rest of his life.

Rodriguez said there will certainly be a rejection – he estimated that about three to five of the other patients who have received facial transplants died after rejection of the new tissue.

“I’m 100 percent convinced it will work. It has to work. But you never know if it’s going to work,” said Hardison shortly after the procedure.

The man with the new face is now starting over and reintroducing himself to his wife, five children, mother and siblings.

Photo: Army Medicine | Flickr