Face transplantation can provide improved quality of life to patients with extensive burn injuries. Facial vascularized composite allotransplantation (VCA) offers a new paradigm of treatment options, serving as a powerful reconstructive tool to restore facial form and function. Although currently facial VCA patients must follow a lifelong regimen of immunosuppression medications and suffer a risk of rejection, in properly selected patients, facial VCA can be a transformative operation and can improve quality of life. Research efforts continue to optimize immunosuppression and surgical technique and serve as evidence of the procedure’s growing role in reconstructive surgery for critically injured patients.
Key points
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Facial disfigurement from burns proves to be a difficult reconstructive challenge.
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Patients with facial disfigurement experience limited quality of life (function, appearance, and social distress).
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Traditional reconstructive techniques commonly yield to unsatisfactory functional and aesthetic results.
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Facial vascularized composite allotransplantation (VCA) has the potential to restore functional and aesthetic derangements beyond conventional reconstructive options.
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Despite the benefits of facial VCA, several issues must be addressed, including patient selection, donor identification, and adverse effects of lifelong immunosuppression, incidence of cancer, infections, and end-organ toxicity.
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