Cameron Underwood's new face: the before and after of the world's most advanced face transplant

In June 2016, Cameron Underwood shot himself in the face. The result was the loss of most of the lower jaw, nose, and all but one of the teeth. He also suffered significant damage to the upper face and palate.

After months of pain and operations, everything seemed to indicate that traditional reconstructive surgery could not do much more. It was then that Cameron's mother read an article about how Dr. Eduardo Rodríguez had carried out a facial transplant in 2012. They separated 4500 kilometers, but they had to try. It was worth it.

The 40th face transplant

For Rodríguez, head of the department of reconstructive plastic surgery at NYU Langone, it was his third transplant. Something exceptional considering that since the first (in France in 2005) only 40 have been made in the world. The previous one had lasted more than 36 hours and had the patient 51 days in intensive care.

But the Underwood case was very interesting. When it came into his hands, not a year had passed since the injury. One of the most important problems in the recovery of these patients is overcoming the emotional and psychological consequences of living with the problem for decades. Underwood could teach us if by reducing the intervention time the rehabilitation was faster.

The donor William Fisher died six months later. He was a 23-year-old young man studying at Johns Hopkins University, playing chess and aspiring to be a filmmaker. In a very short time everything was ready. More than 100 professionals participated in an operation that, thanks to new computerized maps, 3D printed guides and the use of a real-time TAC, lasted 'only' 25 hours.

A rapidly developing surgical area

Technologically, it is the most advanced transplant in the world and used three-dimensional printers, scanners and the most accurate imaging techniques for real-time diagnosis. Transplantation and reconstruction of the maxillary (upper jaw) and mandibular (lower jaw) bones were required, including the 32 teeth and gums; the palate, the floor of the mouth, the lower eyelids, the cheeks and the nose. The tongue and upper eyelids are those of Underwood himself (but they needed some reconstruction).

Since February, Underwood has been in rehab (which included speech therapy and orthodontia) and, although he will remain on rejection medication for life, he has just been fully discharged. The result of the operation is impressive. A small miracle of contemporary science to end the week.

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