28/07/2016 9:45 PM AEST

Graphic New Photos Of Face Transplant Show Burn Patient's Remarkable Rebirth

A year after the pioneering surgery, things are looking up for Patrick Hardison.

Patrick Hardison prior to his face transplant surgery (left) and in February 2016, about six months after surgery.
Patrick Hardison prior to his face transplant surgery (left) and in February 2016, about six months after surgery.
NYU Langone Medical Center
Patrick Hardison before his face transplant surgery.

The doctors behind the most extensive face transplant operation ever performed are out with a new report on the remarkable 26-hour procedure and how it has transformed the life of Patrick Hardison, a former firefighter horribly disfigured by burns sustained in the line of duty.

(Warning: Photos below are graphic.)

The report, published in the July issue of the journal Plastic and Reconstructive Surgery, gives a detailed look at the risky surgery, which took place last August at NYU Langone Medical Center in New York City.

It includes a graphic educational video of the procedure and previously unreleased photos of Hardison and the face donor, including some images that the doctors deemed too gruesome for widespread release ― like this one and this one.

There’s also a blow-by-blow of the surgical techniques used by the team of more than 100 doctors, nurses, technicians and support staff, as well as details on how Hardison, a 42-year-old father of five from Senatobia, Mississippi, has fared since the surgery.

Patrick Hardison prior to his face transplant surgery (left) and in February 2016, about six months after surgery.

The doctors’ aim in preparing the report was to help improve outcomes for all face transplant patients ― especially those with extensive face and scalp burns like Hardison’s.

“Being an academic surgeon, I think it is important that we publish,” Dr. Eduardo D. Rodriguez, the lead surgeon and co-author of the report, told The Huffington Post. “And our experience ― the approach and the basic science ― can help other teams outline how to go about performing these types of operations.”

Rodriguez said he was pleased by the results of the surgery ― believed to be the 37th face transplant ever performed and the only one that involved transplanting the eyelids, ears and scalp, as well as the face ― and the fact that Hardison’s immune system hasn’t rejected the transplanted tissue.

Tissue rejection is a problem for many transplant patients, including another high-profile face transplant recipient, Charla Nash, a Connecticut woman who got a new face in 2011 after being mauled by a chimpanzee in 2009.

Rodriguez is also gratified by the improvement in Hardison’s quality of life.

“We’ve seen that Patrick is integrating into society again,” he said, adding that Hardison no longer must depend on help from his mother and that he has even been able to “jump into the pool,” something he hadn’t been able to do since his injury. 

Not surprisingly, Hardison too is pleased at how things have turned out.

“Even though I understood the risk of undergoing a face transplant, I never once doubted that it was something I needed to do,” Hardison told HuffPost in an email. “For instance, before the surgery, I couldn’t drive and didn’t sleep well since I couldn’t close my eyelids. Now I am able to do both of these things, which has really enhanced my quality of life. “

In addition to enjoying better mobility and sleep, Hardison is now able to speak, breathe and eat with less difficulty. His appearance is also vastly improved, as you can see in the before and after photos above.

Hardison was burned on Sept. 5, 2001, while fighting a house fire in Senatobia, losing his eyelids, ears, lips, most of his nose and all his facial hair. He spent 63 days in the hospital and underwent scores of surgical procedures to repair damaged tissue and restore lost function.

But the loss of tissue and scarring were so extensive that little could be done about his appearance. As a result, Hardison began hiding behind sunglasses and a baseball cap when he ventured out in public.

Hardison lived that way for almost a decade and a half. Then, on the evening of Aug. 12, 2015, he learned in a phone call from New York City that a donor face was available. He flew to New York City the next day. One day later the NYU doctors cut away his badly scarred face and replaced it with the unblemished face of David Rodebaugh, a 26-year-old who had been declared brain-dead after a bicycle accident.

Hardison (left) in uniform before his injury (left) and a snapshot of David Rodebaugh, the face donor.

(Doctors covered Rodebaugh’s denuded face with a lifelike silicone mask created from a mold made after death but before the removal of his face and scalp ― to protect Rodebaugh’s family from needless distress.)

Hardison spent more than two months in the hospital after the transplant and then another month or so in an apartment near the hospital before returning to Mississippi, hospital officials said. In the months since then, he has returned to New York on a regular basis for follow-up care.

Hardison’s life isn’t the same as it was before his injury, of course. And the threat of rejection and other medical problems is ever present. But Hardison recognizes his good fortune in getting a new face ― and is quick to express his gratitude.

As he told HuffPost, “I am eternally grateful to David and his family for giving me this precious gift.”

  • Patrick Hardison Before The Face Transplant Surgery
    Patrick Hardison Before The Face Transplant Surgery
    NYU Langone Medical Center
    Patrick Hardison before the face transplant surgery. At this point he had already undergone more than 70 surgical procedures to address the serious facial and scalp burns that he sustained in 2001.
  • Side View Before Surgery
    Side View Before Surgery
    NYU Langone Medical Center
    The outer parts of Hardison's ears had been severely burned, so he had been fitted with prosthetic ears (not shown here) that could be taken on and off.
  • Rear View
    Rear View
    NYU Langone Medical Center
    This photo, taken before the surgery, shows the pegs used to attach the prosthetic ears.
  • Planning The Incisions
    Planning The Incisions
    NYU Langone Medical Center
    Before the surgery began, Dr. Eduardo Rodriguez used a marker to indicate where on Hardison's face the surgical incisions would be made.
  • On The Operating Table
    On The Operating Table
    NYU Langone Medical Center
    Hardison just before surgery, with marks indicating where the incisions were to be made. The procedure took about 26 hours.
  • Tools Of The Trade
    Tools Of The Trade
    NYU Langone Medical Center
    It took a lot of instruments to perform the surgery -- about 1,000 in all.
  • A Big Team
    A Big Team
    NYU Langone Medical Center
    The surgical team assembled prior to the removal of the donor's face. This is only part of the team, which included more than 100 doctors, nurses, technicians and support staff.
  • Removing The Donor's Scalp
    Removing The Donor's Scalp
    NYU Langone Medical Center
    Before removing the donor's scalp, surgeons marked where the incision was to be made. The semicircular incision shows the spot where doctors had opened the skull in an unsuccessful attempt to save the donor's life. The orangish color is an antiseptic solution.
  • Face Mask
    Face Mask
    NYU Langone Medical Center
    This silicone face mask was used to cover the donor's head after his face had been removed.
  • Preserving The Face
    Preserving The Face
    NYU Langone Medical Center
    Doctors placed the donor face in a preservative solution. It remained in the solution for about an hour before being transplanted.
  • Documenting The Operation
    Documenting The Operation
    NYU Langone Medical Center
    Dr. Alexes Hazen documented the entire procedure. On the wall are various images and documents used to plan the surgery.
  • A Good Sign!
    A Good Sign!
    NYU Langone Medical Center
    Hardison immediately after the carotid artery and the internal jugular vein on the right side of his new face had been connected. The left side of his face is pinker than the right because its blood supply has been restored.
  • Swelling Was Expected
    Swelling Was Expected
    NYU Langone Medical Center
    Hardison immediately after surgery. The swelling was expected. It's part of the recovery process.
  • Stabilizing The Transplant
    Stabilizing The Transplant
    NYU Langone Medical Center
    To stabilize the transplant, doctors had to connect two nerves, four blood vessels and four bony segments. They used sutures, plates and screws.
  • The New Face
    The New Face
    NYU Langone Medical Center
    Hardison on Oct. 25, 2015, 71 days after the surgery. His eyes were still a bit droopy at this point.
  • Patrick After Surgery
    Patrick After Surgery
    NYU Langone Medical Center
    Hardison 71 days after the surgery.
  • Telltale Scar
    Telltale Scar
    NYU Langone Medical Center
    The scar where the surgeons stitched on the new face and scalp is visible at the back of Hardison's head.
  • Patrick's New Look
    Patrick's New Look
    NYU Langone Medical Center
    Patrick Hardison as he looked in February 2016, about six months after the surgery.