US man gets new lease of life after groundbreaking face transplant

Dubai: A Michigan man’s life has been transformed through a groundbreaking face transplant.

Derek Pfaff, 30, can now smile, blink, eat, and breathe through his nose for the first time in a decade — an outcome he calls his “second chance at life.”

Pfaff’s life changed forever on March 5, 2014, during his college years, when a suicide attempt left him with devastating facial injuries. “It was a really dark time in my life,” Pfaff recalls. “I don’t remember much about that day, but I woke up in the hospital with severe facial injuries. It was a life-changing moment.”

Over the next 10 years, Pfaff underwent 58 reconstructive surgeries. These operations enabled him to survive but couldn’t restore his ability to eat solid food, speak clearly, or even wear glasses. “Life was incredibly challenging,” Pfaff says. “I felt isolated and alone. Simple things like eating a meal or having a conversation were difficult. It was a constant reminder of what I had lost.”

The decision for a face transplant

Pfaff’s doctors eventually referred him to Mayo Clinic, where he became a candidate for the institution’s second face transplant. According to Dr Samir Mardini, surgical director of Mayo Clinic’s Reconstructive Transplant Programme, Pfaff’s case was uniquely complex.

“Patients with his situation, where the centre of the face is missing some of its natural parts, are very difficult to reconstruct with conventional methods,” Dr Mardini said.

The multidisciplinary team evaluated Pfaff and prepared for nine months to ensure the success of the surgery. “The preparations included digital surgical planning using detailed scans, facial nerve mapping, and virtual surgical rehearsals,” Dr Mardini said.

The team also utilised the latest technology in medical modeling and 3D printing, creating customized guides for precise execution.

Marathon surgery

In February 2024, a donor became available, and the team embarked on a 50-hour surgical marathon. “In Pfaff’s case, the donor tissue included part of the forehead, upper and lower eyelids, the nose, mouth, jaws, teeth, as well as the skin, muscles, and nerves of the face and neck,” said Dr Mardini.

The most intricate aspect was reconnecting the many small nerves between Pfaff and the donor, a critical step to restore facial functions such as blinking, smiling, and chewing. Dr Mardini notes that this process required meticulous mapping and innovative microsurgical techniques, including the transplantation of the donor’s tear drainage system. “We used a new microsurgery technique to transplant the tear drainage system. The entire procedure lasted over 50 hours.”

“Also new is transplanting the forehead bones with the nose and the rest of the structures of the face all in one piece.  The right upper and lower eyelids were transplanted together with fat from the orbit of the donor to restore volume to the area of the right orbit.” 

“Six plastic surgeons and a multidisciplinary team of over 80 medical professionals were involved, including anesthesiologists, nurses, technicians, assistants, and specialists from Plastic and Reconstructive Surgery, Transplant, Nephrology, Neurology, Ophthalmology, Dermatology, Pathology, Radiology, Critical Care, Anesthesia, Psychiatry, Infectious Diseases, Histocompatibility, Pharmacy, Nursing, Social Work, Rehabilitation, and Speech and Language Pathology.

“The combined expertise played a key role in the success of this highly complex procedure, from pre-operative planning and surgical execution to post-operative care and rehabilitation.”

The surgery was followed by months of additional procedures to refine Pfaff’s appearance and improve his functionality. Today, Pfaff can smile and express emotions naturally, thanks to the successful reconnection of 18 facial nerve branches.

Life after the transplant

The results have been life-changing for Pfaff. “This surgery has transformed my life,” he says. “I can eat, talk, and smile again. I feel so much more confident. I am hoping to meet someone, settle down, and have a family.” Pfaff has also found purpose as a public speaker for suicide prevention, sharing his story to inspire others.

His parents, Lisa and Jerry Pfaff, are overwhelmed with gratitude. “It makes my heart so full to see him smile and happy and just be a normal person again,” Lisa says.

Jerry adds, “It’s been 10 years since we’ve seen a nose, lips, and teeth on our son. It’s just totally amazing—a miracle.”

The medical breakthrough

Pfaff’s face transplant highlights the exceptional skill and dedication of Mayo Clinic’s multidisciplinary team, which included over 80 specialists. The procedure represents significant advancements in medical modeling, 3D printing, and nerve reconstruction.

“Face transplant is a rare surgery. There are only a few teams around the world that are doing them,” Dr Mardini says. “The restorative nature of the facial transplant makes it very complex, particularly the intricate nerve reconnections necessary to restore facial function. The biggest challenge is achieving the functions that Pfaff was missing and achieving the goal of having Pfaff appear as a normal person and not as someone who had a face transplant.”  

“This surgery is not just about aesthetics,” says Dr Mardini. “It’s about restoring functions that allow a person to live a normal life.” While the risk of immune rejection exists, Pfaff’s condition is being closely managed with standard immunosuppressive therapies.

A message of hope

Pfaff’s story is one of resilience and hope. “I lived for a reason,” he says. “I want to help others in any way I can.” Thanks to a generous donor and the groundbreaking efforts of his medical team, Pfaff now has a renewed sense of purpose and is ready to embrace the future.

For Mayo Clinic, this success is a testament to the power of innovation and collaboration, paving the way for advancements in facial transplantation and offering new hope to patients with severe facial disfigurements.