Achievements and Challenges in Facial Transplantation

@article{Rifkin2018AchievementsAC,
  title={Achievements and Challenges in Facial Transplantation},
  author={William J. Rifkin and Joshua A. David and Natalie M. Plana and Rami S. Kantar and Jesus Rodrigo Diaz-Siso and Bruce E Gelb and Daniel J Ceradini and Eduardo D Rodriguez},
  journal={Annals of Surgery},
  year={2018},
  volume={268},
  pages={260–270}
}
&NA; The first facial transplantation in 2005 ushered in a new era in reconstructive surgery, offering new possibilities for the repair of severe disfigurements previously limited by conventional techniques. Advances in allograft design, computerized preoperative planning, surgical technique, and postoperative revisions have helped push the boundaries in this new frontier of vascularized composite allotransplantation. Over the past 12 years, 40 of these procedures have been performed across the… 
Face of the Future: Lessons Learned and Opportunities in Composite Allotransplantation.
TLDR
In its brief history, facial allotransplantation has materialized into an effective reconstructive option for patients with extensive disfigurements who are not amenable to conventional surgical approaches, resulting in good aesthetic and functional outcomes.
The 2020 Facial Transplantation Update: A 15-Year Compendium
TLDR
This article provides the most comprehensive and up-to-date facial transplantation review, highlighting fundamental lessons learned and recent advancements, while looking toward the challenges ahead.
Facial Transplantation.
Maxillofacial Bony Considerations in Facial Transplantation.
TLDR
The current literature and considerations specific to bony facial transplantation focusing on the pertinent surgical anatomy, preoperative planning needs, intraoperative harvest and inset considerations, and postoperative protocols are reviewed.
Facial Transplantation: Complications, Outcomes, and Long-Term Management Strategies.
TLDR
The medical and surgical advancements in facial transplantation surgery are reflected and anticipated future challenges are highlighted to encourage discussion regarding anticipated barriers to current practice and suggest future directions as the authors transition into the next phase of facial allograft transplantation.
Facial Transplantation for an Irreparable Central and Lower Face Injury: A Modernized Approach to a Classic Challenge.
TLDR
Relying on a multidisciplinary collaborative approach, coupled with innovative emerging technologies and immunosuppression protocols, can overcome significant challenges in facial transplantation and reinforce its position as the highest rung on the reconstructive ladder.
Autologous Reconstruction of a Face Transplant Candidate
TLDR
The objective is to clarify the criteria that make a patient a suitable face transplant candidate, as well as to demonstrate the outcomes achievable with a conventional autologous reconstruction, using a methodically planned, multistaged approach.
Otologic considerations in a full face transplant recipient
TLDR
The case of a 44‐year‐old man who underwent transplantation of the total face, eyelids, ears, scalp, and skeletal subunits in 2015 after an extensive thermal injury is described.
Facial Transplantation: Principles and Evolving Concepts
TLDR
This CME article highlights principles and evolving concepts in facial transplantation, the highest rung on the reconstructive ladder for patients with extensive facial disfigurement who are not amenable to autologous reconstructive approaches, in pursuit of optimal functional and aesthetic outcomes.
Computerized Approach to Facial Transplantation: Evolution and Application in 3 Consecutive Face Transplants
TLDR
A CSP protocol allows for refinement of operative flow, technique, and outcomes in partial and full FT, and computerized planning and execution offer a reproducible approach to FT through objective quality assurance.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 77 REFERENCES
Face transplantation: Complications, implications, and an update for the oncologic surgeon
TLDR
The ability to simultaneously restore facial function and aesthetics has shown to improve patient's quality of life, however, its applicability to post‐oncologic resection remains guarded given the current international experience with respect to long term outcomes.
Three patients with full facial transplantation.
TLDR
Three patients who received full-face transplants at this institution in 2011 in operations that aimed for functional restoration by coaptation of all main available motor and sensory nerves are reported on.
Discussion: Watershed Areas in Face Transplantation.
TLDR
International experience in maxilla-containing facial transplantation is summarized, correlating vessel choice to palatal fistula/necrosis is correlated, and a modified dissection technique is proposed that aims to prevent these complications.
Technology and vascularized composite allotransplantation (VCA)—lessons learned from the first bilateral pediatric hand transplant
The reconstructive principle of replacing “like with like” is best met with vascularized composite allotransplantation in which the components of an existing defect are “matched” to the greatest
Surgical aspects of a lower face, mandible, and tongue allotransplantation.
TLDR
The technical aspects of a composite lower face transplantation including the tongue, floor of the mouth, and most of the mandible are detailed and the patient is swallowing, without evidence of malignancy recurrence or HIV replication at 16 months posttransplantation.
Principles of Face Transplant Revision: Beyond Primary Repair
TLDR
Following the most extensive face transplant performed to date, postoperative revisions are performed in two surgical procedures, including soft-tissue revision, hard-tissues mismatch, and craniofacial skeleton and dental occlusion, addressing four distinct categories of revisions.
Complex facial reconstruction by vascularized composite allotransplantation: the first Belgian case.
...
1
2
3
4
5
...