A pilot study in sub-SMAS face transplantation: Defining donor compatibility and assessing outcomes in a cadaver model

Background: Face transplantation may become a viable alternative in the treatment of patients with severe acquired facial deformity. In this study, the authors investigate morphological compatibility between donor and recipient by assessing chimeric outcomes in a human cadaver model. Methods: Four faces were harvested from fresh human cadaver specimens in a surgical plane deep to the galea, to the superficial musculoaponeurotic system, and to the platysma. The faces were subsequently exchanged among the four donor crania, simulating full-face transplantations. Eight cranium-face chimera complexes were created and analyzed with standardized photography and with volumetric computed tomographic radiography. Results: Four morphological parameters to consider in determining donor/ recipient compatibility were defined: (1) skin color and texture, (2) head size, (3) soft-tissue features, and (4) gender. Conclusion: Careful selection of face donors based on compatibility criteria will aid in ensuring that the posttransplant outcome is morphologically similar to the recipient's native face.