The most extensive facial transplant in medical history

Rodriguez laid Rodebaugh’s face over Hardison’s head. He “snap fit” the tips of the cheekbones and chin, and the nose with screws and metal plates, securing the face in position. He attached two whitish cables of sensory nerves to Hardison’s lips, which perform the face’s most complicated movements. Other nerves would regenerate, creating pathways to the new face. Eventually, hopefully, Hardison would have sensation. Scar tissue would bind pinkish strands of muscles to the remnant muscles of Rodebaugh’s face and eventually power his smile, his cheeks, the wrinkling of his forehead.

All was going according to plan until Rodriguez attempted to sew Rodebaugh’s internal jugular vein to Hardison’s. There was a size mismatch: Hardison’s jugular was bigger. A suture failed and Hardison lost a couple pints of blood in a couple minutes. Rodriguez clamped the external carotid, stopping blood flow to the entire face, and changed his approach. Instead of joining the jugulars end to end, he cut a hole in the side of one, allowing him to control the size of the opening, and sewed the other to it. After 30 minutes, he unclamped the carotid and let blood flow through the face. The pale cheeks turned pink. He pricked Hardison’s lips with a pin. They bled, a relief.

It was Hardison’s face now, though it seemed to have a will of its own. The face started to swell. It was expected, but still striking. In a few minutes, the face was 50 percent larger than it had been. “It looked like a boxer’s face at the end of 15 rounds,” said Rodriguez.