Computerized Approach to Facial Transplantation: Evolution and Application in 3 Consecutive Face Transplants

Area of Science:

• Reconstructive surgery
• Surgical innovation
• Medical imaging

Background:

• Face transplant (FT) candidates often have complex defects not amenable to traditional reconstruction.
• Accurate allograft design and transplantation are critical challenges in FT.
• Patient-specific allografts require precise planning for successful outcomes.

Purpose of the Study:

• To present a comprehensive computerized surgical planning (CSP) protocol for face transplantation.
• To evaluate the efficacy and outcomes of CSP in FT procedures.
• To demonstrate the refinement of operative flow and technique through CSP.

Main Methods:

• Incorporation of CSP, computer-aided design and manufacturing, intraoperative navigation, and intraoperative CT.
• Performance of three consecutive FTs (two full, one partial) using the CSP protocol.
• Comparison of CSP and postoperative results using CT-derived cephalometric measurements.

Main Results:

• Successful execution of two full and one partial FT with minor cephalometric variations.
• Reduced reliance on cadaveric simulation and mock transplants over time.
• Significant reduction in operative time (36 to 25 hours) and need for surgical revision.

Conclusions:

• CSP protocol refines operative flow, technique, and outcomes in FT.
• Computerized planning and execution offer a reproducible approach to FT.
• CSP facilitates objective quality assurance for functional and esthetic outcomes in face transplantation.