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Updated: May 26, 2026
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Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
Published on: December 30, 2025
Three patients with full facial transplantation
Bohdan Pomahac1, Julian Pribaz, Elof Eriksson
1Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. bpomahac@partners.org
The New England Journal of Medicine
|December 30, 2011
Summary
Full-face transplantation offers a single-operation solution for severe facial deformities. This study shows successful allograft survival, improved function, and successful glucocorticoid withdrawal at 6 months post-transplant.
Area of Science:
- Surgical innovation in reconstructive medicine.
- Transplantation surgery.
- Facial reconstruction and restoration.
Background:
- Facial deformities often require complex, multi-stage reconstructive surgeries.
- Facial transplantation presents a novel approach for single-stage correction of severe facial defects.
- Restoring both form and function is a primary goal in facial transplantation.
Observation:
- Three patients underwent full-face transplantation in 2011.
- Operations focused on coapting all available motor and sensory nerves for functional restoration.
- Technical challenges and postoperative complications were meticulously managed.
- Acute rejection episodes occurred in two patients but were managed successfully.
Findings:
- All facial allografts survived at the 6-month follow-up.
- Patients demonstrated improved facial appearance and restored function.
- Successful withdrawal of glucocorticoid immunosuppression was achieved in all three patients.
Implications:
- Facial transplantation is a viable option for severe facial deformities.
- Nerve coaptation is crucial for functional recovery after facial transplantation.
- Optimized immunosuppression protocols may allow for glucocorticoid withdrawal, reducing long-term side effects.
