TY - JOUR
T1 - Total face, double jaw, and tongue transplantation
T2 - An evolutionary concept
AU - Dorafshar, Amir H.
AU - Bojovic, Branko
AU - Christy, Michael R.
AU - Borsuk, Daniel E.
AU - Iliff, Nicholas T.
AU - Brown, Emile N.
AU - Shaffer, Cynthia K.
AU - Kelley, T. Nicole
AU - Kukuruga, Debra L.
AU - Barth, Rolf N.
AU - Bartlett, Stephen T.
AU - Rodriguez, Eduardo D.
PY - 2013/2
Y1 - 2013/2
N2 - BACKGROUND: The central face high-energy avulsive injury has been frequently encountered and predictably managed at the R Adams Cowley Shock Trauma Center. However, despite significant surgical advances and multiple surgical procedures, the ultimate outcome continues to reveal an inanimate, insensate, and suboptimal aesthetic result. METHODS: To effectively address this challenging deformity, a comprehensive multidisciplinary approach was devised. The strategy involved the foundation of a basic science laboratory, the cultivation of a supportive institutional clinical environment, the innovative application of technologies, cadaveric simulations, a real-time clinical rehearsal, and an informed and willing recipient who had the characteristic deformity. RESULTS: After institutional review board and organ procurement organization approval, a total face, double jaw, and tongue transplantation was performed on a 37-year-old man with a central face high-energy avulsive ballistic injury. CONCLUSIONS: This facial transplant represents the most comprehensive transplant performed to date. Through a systematic approach and clinical adherence to fundamental principles of aesthetic surgery, craniofacial surgery, and microsurgery and the innovative application of technologies, restoration of human appearance and function for individuals with a devastating composite disfigurement is now a reality. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
AB - BACKGROUND: The central face high-energy avulsive injury has been frequently encountered and predictably managed at the R Adams Cowley Shock Trauma Center. However, despite significant surgical advances and multiple surgical procedures, the ultimate outcome continues to reveal an inanimate, insensate, and suboptimal aesthetic result. METHODS: To effectively address this challenging deformity, a comprehensive multidisciplinary approach was devised. The strategy involved the foundation of a basic science laboratory, the cultivation of a supportive institutional clinical environment, the innovative application of technologies, cadaveric simulations, a real-time clinical rehearsal, and an informed and willing recipient who had the characteristic deformity. RESULTS: After institutional review board and organ procurement organization approval, a total face, double jaw, and tongue transplantation was performed on a 37-year-old man with a central face high-energy avulsive ballistic injury. CONCLUSIONS: This facial transplant represents the most comprehensive transplant performed to date. Through a systematic approach and clinical adherence to fundamental principles of aesthetic surgery, craniofacial surgery, and microsurgery and the innovative application of technologies, restoration of human appearance and function for individuals with a devastating composite disfigurement is now a reality. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
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U2 - 10.1097/PRS.0b013e3182789d38
DO - 10.1097/PRS.0b013e3182789d38
M3 - Article
C2 - 23076416
AN - SCOPUS:84873312546
SN - 0032-1052
VL - 131
SP - 241
EP - 251
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 2
ER -