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Semin Plast Surg 2020; 34(04): 245-253
DOI: 10.1055/s-0040-1721760
Review Article

Facial Transplantation: Complications, Outcomes, and Long-Term Management Strategies

Tom Shokri
1   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
,
Robert Saadi
2   Department of Otolaryngology – Head & Neck Surgery, Penn State Health, Hershey, Pennsylvania
,
Weitao Wang
1   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
,
Likith Reddy
3   Department of Oral and Maxillofacial Surgery, Texas A&M College of Dentistry, Dallas, Texas
,
Yadranko Ducic
1   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
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Abstract

Within the past two decades, vascularized facial composite allotransplantation has evolved into a viable option in the reconstructive surgeons' armamentarium for patients with extensive facial disfigurements. As it has expanded the frontiers of microsurgical reconstructive techniques, facial transplantation has come to garner widespread interest within both the medical community and the general public. The procedure has established itself as an amalgamation of the forefronts of reconstructive microsurgery, immunology, and transplantation science. Therein too lies its complexity as multifaceted scientific developments are met with ethical and social issues. Both patients and physicians are faced with the everlasting challenges of immunosuppression regimens and their inherent complications, long-term aesthetic and functional considerations, the role of revision procedures, and the inevitable psychosocial implications. This article reflects on the medical and surgical advancements in facial transplantation surgery and highlights anticipated future challenges. It aims to encourage discussion regarding anticipated barriers to current practice and suggest future directions as we transition into the next phase of facial allograft transplantation.

Keywords

facial transplantation - composite tissue allotransplantation - microvascular surgery - immunosuppression - ethics

Disclosures

The authors have no disclosures.




Publication History

Article published online:
24 December 2020

© 2020. Thieme. All rights reserved.

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