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World’s Most Extensive Face Transplant Gets Hand From 3D Modeling: How 3D Printing Improves Facial Surgeries

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Facial surgeries are most often recommended in patients who have undergone accidents that have caused parts of their faces to become different from what it used to be. Ultimately, a facial transplant is prescribed if the trauma is so severe that it has caused a person's face to look anything but the original.

Sept. 5, 2001 was an unforgettable day for 27-year-old Patrick Hardison, a volunteer firefighter. While in the middle of a fire rescue, Hardison got caught as the ceiling collapsed. His face burned but fortunately, by closing his eyes, his vision was saved.

Hardison underwent a total of 71 surgeries in a span of 14 years. While these procedures let him survive day by day, a friend recommended him to see Dr. Eduardo Rodriguez, who has performed a facial reconstruction surgery before. In 2012, the New York University Langone Medical Center surgeon accepted Hardison as his patient. All they needed then was a face donor.

In July 2015, David Rodebaugh, 26, sustained a bike accident and was declared brain dead in August 2015. He was a donor match for Hardison and so when the consents and preparations have all been settled, Rodriguez's team performed what may be the world's most extensive face transplant.

The surgery initially began in Aug. 14, 2015 but before the said procedure, comprehensive pre-planning activities were performed. Among the most extensive strategy was 3D imagery and printing.

Through 3D models created via CT scans of both Hardison and Rodebaugh, the medical team was able to approach the procedure in a significantly convenient way. The doctors were able to come up with accurate measurements, millimeter by millimeter. They were able to figure out and plan exactly how the procedure was going to be - from using donor bones, connecting arteries and veins to re-draping the skin. Surely, the 3D images played a huge role in the success of the procedure.

In 2014, a study led by Frank J. Rybicki, a radiologist from Brigham and Women's Hospital in Boston, evaluated the effects of 3D printed models of transplant recipients' heads in the planning of facial transplant.

For the said research, all the transplant recipients underwent CT scan with 3D visualization before the surgery. The images generated were segmented and processed using a customized program, developing specialized data files that were run through a 3D printer to create an actual-sized skull.

The models benefitted the surgeons during the procedure because they were able to have a better picture of the patient's skull anatomy. "You can spin, rotate and scroll through as many CT images as you want but there's no substitute for having the real thing in your hand," said Rybicki. "The ability to work with the model gives you an unprecedented level of reassurance and confidence in the procedure."

Rycbicki also said that that face transplant is a complicated procedure and that its success largely depends on the planning stage. In the study, they were able to show that using 3D models and holding the skull by the hand is the best technique to employ.

Senior radiologists and surgeons also agreed that 3D printed models were able to give outstanding data prior to surgery and showed better presentation of bone defects and complex anatomical features. With this, 3D printing saves time and effort, and provides more enhanced surgical success.

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