30/11/2018 11:02 GMT | Updated 30/11/2018 14:44 GMT

Full Facial Transplant Success For 26-Year-Old Man As Doctors Show How Far Operation Has Come

The operation took 25 hours.

A man from California has undergone a successful full face transplant after a self-inflicted gunshot wound left him with life-changing injuries.

Cameron Underwood, 26, underwent the 25-hour surgery just 18 months after his accident: the shortest window between the two in publicly reported cases in the United States, the hospital said. 

This was helped by the fact he only waited six months for a donor – William Fisher. Fisher was a 23-year-old who registered as an organ donor in his teens and donated his face, heart, kidneys, livers, eyes and other tissues. 

The surgery at NYU Langone Health in New York was technologically advanced and required the replacement of Underwood’s upper, mid and lower face and his jaw after his injury left him without his lower jaw, nose and any teeth. 

He also experienced damage to his upper face and palate.

Beverly Bailey-Potter, Underwood’s mother, saw an article in a magazine about the team of surgeons led by Dr. Eduardo Rodriguez on the east coast and decided she wanted him to help.

“We knew he was the only person to whom we would trust Cameron’s life,” she said a statement. “We were willing to travel the long distance.”

This is only the second time the procedure has been carried out by the team – one of a handful in the US, and around the world, with the expertise to do so. There have been around 40 face transplants globally since the first in 2005. 

Underwood was discharged from the hospital in mid-February and will remain on anti-rejection drugs throughout his life, but to date has responded well. 

As well as his face transplant he is also undergoing speech therapy and orthodontic treatment.

The world’s first partial face transplant on a living human was carried out in Amiens, France in November 2005. Isabelle Dinoire, 38 had been bitten by a dog and had her lips, chin and parts of her cheeks destroyed. The operation  transplanted facial tissue from a recently deceased 46-year-old woman. 

The world’s first full face transplant was completed in Barcelona, Spain in 2010. A Spanish farmer, known as Oscar had an entire face lifted – including jaw, nose, cheekbones, muscles, teeth and eyelids – after a gun accident.

In October 2006, surgeon Peter Butler at London’s Royal Free hospital in the UK was given permission by the NHS ethics board to carry out face transplants.

TurkeyFrance, the US and Spain (in order of total number of successful face transplants) are the leading countries conducting research into the procedure.

But despite the many advances made, as shown by cases like Underwood’s, there are still hurdles to overcome.

Apart from finding the right match, patients face taking immuno-suppressant drugs for the rest of their lives. These increase the risk of infection and cancer and generally weaken muscles and bones.