Face transplant surgery procedures

Face transplant surgery procedures at the Royal Free

Face transplants have only recently become a possibility, after discussions and research from various bodies – including the facial transplantation team Royal Free London. Here are some of the main plastic surgery procedures and techniques used when performing face transplants.

Microsurgery to reconnect the blood supply of ‘allografts’

Transplanted tissues from donors – also known as allografts – must receive an adequate supply of blood to survive. A microsurgery technique known as 'free tissue transfer' allows this to happen by disconnecting the blood supply of the donor tissue and reconnecting the tissue, under precise microscopic control, to the recipient’s blood vessels at the new location. 

Microsurgery of this kind is now very reliable and occurs in most plastic surgery procedures – including face transplants. 

Maintaining facial function after reconstructive surgery by removing dead tissue

Maintaining the function of donated tissues after plastic surgery procedures is highly important – especially when it comes to full-face transplants. The approach of our UK face transplant team is to maintain as much movement as possible by removing damaged tissues while avoiding damaging nerves. The facial function usually returns after facial transplantation when the burnt skin and scar tissue, which restricts movement, is removed and the patient's muscles are free to move. Some groups have suggested using facial nerves and muscles in the facial transplant but plastic surgeons in the UK avoid this approach because transplanted facial nerves are unlikely to recover function under current plastic surgery procedures.

Repairing an avulsion injury: when a patient’s face has been ripped away 

It was demonstrated that a face transplant would be technically possible when a team of plastic surgeons in India reattached the face of a girl after she sustained a severe avulsion injury and her face was ripped off when her hair became caught in a machine. 

Pictures from before and after the plastic surgery are shown below. The girl’s facial mask is first shown, before it was reattached, and the following picture shows how the girl looked after plastic surgery.

Find out more about the first face transplants to be performed in Europe and the work of our UK face transplant team, see the left hand navigation.