At Mayo Clinic, doctors from many specialties work as a team to develop the most appropriate treatment plan for you. Your team will take time to listen to your questions and concerns and provide comprehensive care, which includes nutritional, social, financial and spiritual issues. Mayo Clinic professionals follow you before, during and after your transplant, to ensure the best results and quality of care.
Before your transplant
Doctors specializing in face transplantation will evaluate you to determine whether a face transplant may be an option for you. Face transplant may be an option for people who have severe facial deformity.
Your evaluation may include appointments spanning a period of several months and may include:
- Physical examination.
- Blood tests, including blood and tissue type analysis.
- X-rays and CT scans.
- Physical and occupational therapy tests.
- Nerve function assessment.
- Psychological consultation.
- Consultations with specialists in facial reconstruction surgery, transplant surgery, social services and others.
- Consultations with a financial coordinator to determine financial and insurance information for your transplant.
In addition, doctors will discuss with you what to expect after a face transplant, including taking medications and lifestyle and other changes. Doctors also will explain to you the risks and benefits of transplant.
If doctors determine that you're eligible for a face transplant, you'll be placed on a waiting list. Your transplant team will select a healthy face from a deceased donor. Doctors consider your blood type, face size, sex, skin color and other factors when selecting a donor.
While on the waiting list, remain in close contact with the transplant team, and notify your transplant coordinator of any significant changes in your medical or social situation. Be prepared to get to the hospital quickly after you receive notice that a donor face is available. Also, maintain your general health as much as possible.
Transplant surgery
A face transplant is a lengthy procedure lasting 10 or more hours. In face transplant, a team of surgeons reattaches bones, arteries, veins, tendons, muscles, nerves and skin.
After your surgery, you'll likely remain in the hospital 2 to 4 weeks. During your hospital stay, your transplant team will monitor your recovery process, including helping you manage your pain, assisting with emotional concerns, providing you with education and checking for signs of complications. Surgeons will monitor your skin coloration and blood circulation. You'll also begin therapy to help you gain facial function.
Your treatment team will provide you with instructions on post-transplant recovery, care, lifestyle changes and medications. You'll also be given contact information for your transplant doctor and transplant coordinator.
After your transplant
You'll need to stay near Mayo Clinic for several weeks after your transplant so that doctors can monitor your progress and recovery.
Follow-up care. After discharge from the hospital, you'll have regular appointments at Mayo Clinic, several days a week for several weeks. In follow-up appointments, doctors will conduct blood tests and other tests to check for signs of infection or rejection. Doctors also may remove very small pieces of your skin (skin biopsy) from the transplanted face to check for signs of rejection. You'll also have facial therapy as appropriate for your situation.
After you return home, you'll have regular follow-up appointments at Mayo Clinic once a year, or more frequently if necessary. Your doctor will update your primary healthcare provider about your progress and give recommendations for your care at home. You'll continue to participate in therapy to regain function.
In addition, a certified transplant nurse coordinator will provide you with follow-up care for many months. The coordinator will be available to answer your questions and communicate with you and your primary healthcare provider.
Medications. You'll need to take medications daily, often for life, to keep your body from rejecting your donor face (immunosuppressive medications). Mayo Clinic doctors study the effects of these medications, including their side effects and their effects on nerve recovery.
Nerve recovery occurs gradually in transplant. Nerve function usually takes several months to recover after a transplant. Your function may continue to improve over several years.
One immunosuppressive medication, tacrolimus (Prograf), may speed nerve recovery. Faster nerve recovery may reduce the amount of time before you begin to experience sensations, and function may return sooner. Doctors continue to study immunosuppressive medications to determine their effects on nerve recovery.
Returning to wellness. The transplant team considers your return to wellness after your transplant a priority. You'll be given specific guidelines to return to wellness through facial therapy and a nutrition plan. Staff may give you other lifestyle recommendations, such as wearing sunscreen. Your transplant team will help you make healthy lifestyle choices to achieve an optimal transplant outcome.