title: Surgical Technique of Hemi-Face Transplant: A New Model of Training.
abstract: OBJECTIVE
  Face transplantation from cadaveric donors is an alternative that has been explored as a way to overcome the disadvantages of reconstructive plastic surgery for patients with severe facial deformities, when its approaches are not able to offer good aesthetic and functional results. In this study, the authors describe the surgical technique of face transplantation in swine, investigating the reproducibility of the methods as an experimental model in transplantation.
  
  
  METHODS
  Seven swines were operated upon. After euthanasia, the left hemifacial area was removed and implanted onto the same location on the same animal from which it was removed. The vascular pedicle was based on the facial artery, the caudal auricular artery, and the external jugular vein. The ventral buccal and dorsal buccal branches of the facial nerve and the transverse facial branch of the auricular nerve were taken into the flap.
  
  
  RESULTS
  The mean time of the procedure was 4.5 hours. Differences in vascularization were found as the vessel that provides blood supply to auricular region can be the caudal auricular artery, instead of the temporal artery, as described in the literature. Operative difficulty increases if the animal is more obese. The medical student had training in microsurgical procedures to be able to perform the entire procedure.
  
  
  CONCLUSIONS
  This study describes an experimental model of face transplantation in swine, providing a good model for training of the surgical technique. The method is reproducible in any setting that offers resources in experimental surgery and microsurgery.
authors.affiliation: *Federal University of Paraná †Surgery Department ‡Veterinary Medicine Department, Federal University of Paraná §Plastic Surgery Department, Federal University of Paraná, Curitiba, Brazil.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cunico
authors.forename: Alfredo Benjamim
authors.initials: AB
authors.lastname: Duarte da Silva
authors.forename: Juliana Sperotto
authors.initials: JS
authors.lastname: Brum
authors.forename: Rogério Ribeiro
authors.initials: RR
authors.lastname: Robes
authors.forename: Renato
authors.initials: R
authors.lastname: da Silva Freitas
mesh_terms: D000818:Animals; D001158:Arteries / Q000601:surgery; D001938:Brazil; D004195:Disease Models, Animal; D004431:Ear, External / Q000601:surgery; D005145:Face / Q000601:surgery; D005154:Facial Nerve / Q000601:surgery; D054445:Facial Transplantation / Q000193:education* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008953:Models, Anatomic; D008962:Models, Theoretical; D015203:Reproducibility of Results; D013524:Surgical Flaps / Q000601:surgery; D013536:Suture Techniques; D013552:Swine; D013699:Temporal Arteries / Q000601:surgery