title: Facial transplantation: historical developments and future directions.
abstract: OBJECTIVE
  To present the clinical outcomes obtained by the first facial transplant teams worldwide, reviewing current practice and addressing controversies.
  
  
  METHODS
  A bibliographic search of Medline and Embase databases was performed, and a comparative analysis of all articles published from 1980 to the present was conducted. Two independent investigators screened the manuscripts in accordance with pre-defined criteria.
  
  
  RESULTS
  A total of 12 partial and 5 full facial transplants were recorded in the literature. Procedures included partial and near-total facial myocutaneous flaps, and complex osteomyocutaneous grafts. Fifteen patients had fully vascularised grafts, and two patients died of transplant-related and infectious complications.
  
  
  CONCLUSIONS
  Facial transplantation can restore quality of life and enable the social re-integration of recipients. Results published by the first facial transplant teams are promising. However, long-term reports of aesthetic and functional outcomes are needed to more precisely define outcomes. In addition, significant technical, medical and ethical issues remain to be solved.
authors: ENT Department, Lewisham Health Care NHS Trust,London,UK.
authors: G L
authors: GL
authors: Garrett
authors: ENT Department, Royal Free London NHS Foundation Trust,UK.
authors: I
authors: I
authors: Beegun
authors: ENT Department, Lewisham Health Care NHS Trust,London,UK.
authors: A
authors: A
authors: D'souza
mesh_terms: D000328:Adult; D004954:Esthetics; D005145:Face / Q000601:surgery*; D054445:Facial Transplantation / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000639:trends
keywords: Composite Tissue Allografts