title: Total Face, Eyelids, Ears, Scalp, and Skeletal Subunit Transplant: A Reconstructive Solution for the Full Face and Total Scalp Burn.
abstract: BACKGROUND
  Reconstruction of extensive facial and scalp burns can be increasingly challenging, especially in patients that have undergone multiple procedures with less than ideal outcomes resulting in restricting neck and oral contractures, eyelid dysfunction, and suboptimal aesthetic appearance.
  
  
  METHODS
  To establish a reconstructive solution for this challenging deformity, a multidisciplinary team was assembled to develop the foundation to a facial vascularized composite allotransplantation program. The strategy of developing and executing a clinical transplant was derived on the basis of fostering a cohesive and supportive institutional clinical environment, implementing computer software and advanced technology, establishing a cadaveric transplant model, performing a research facial procurement, and selecting an optimal candidate with the aforementioned burn defect who was well informed and had the desire to undergo face transplantation.
  
  
  RESULTS
  Approval from the institutional review board and organ procurement organization enabled our face transplant team to successfully perform a total face, eyelids, ears, scalp, and skeletal subunit transplant in a 41-year-old man with a full face and total scalp burn.
  
  
  CONCLUSIONS
  The culmination of knowledge attained from previous experiences continues to influence the progression of facial vascularized composite allotransplantation. This surgical endeavor methodically and effectively synchronized the fundamental principles of aesthetic, craniofacial, and microvascular surgery to restore appearance and function to a patient suffering from failed conventional surgery for full face and total scalp burns. This procedure represents the most extensive soft-tissue clinical face transplant performed to date.
  Therapeutic, V.
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Michael
authors.initials: M
authors.lastname: Sosin
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Ceradini
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Alexes
authors.initials: A
authors.lastname: Hazen
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: David A
authors.initials: DA
authors.lastname: Staffenberg
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Pierre B
authors.initials: PB
authors.lastname: Saadeh
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Roberto L
authors.initials: RL
authors.lastname: Flores
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Nicole G
authors.initials: NG
authors.lastname: Sweeney
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: G Leslie
authors.initials: GL
authors.lastname: Bernstein
authors.affiliation: New York, N.Y.|From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D004423:Ear / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D054445:Facial Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000293:injuries / Q000601:surgery*; D014019:Tissue Donors; D066027:Transplant Recipients; D016896:Treatment Outcome