Twin tragedies give survivor boon for life

Rochester, Minn.: He’d been waiting for this day, and when his doctor handed him the mirror, Andy Sandness stared at his image and absorbed the enormity of the moment: He had a new face, one that had belonged to another man.

His father and his brother, joined by several doctors and nurses at Mayo Clinic, watched as he studied his swollen features.

He was just starting to heal from one of the rarest surgeries in the world — a face transplant, the first at the medical centre. He had the nose, cheeks, mouth, lips, jaw, chin, even the teeth of his donor. Resting all day in the hospital, he still couldn’t speak clearly, but he had something to say. He scrawled four words in a spiral notebook: “Far exceeded my expectations,” he wrote, handing it to Dr. Samir Mardini, who read the message. “You don’t know how happy that makes us feel,” Mardini said.

The exchange came near the end of an extraordinary medical journey that revolved around two young men. Both were rugged outdoorsmen and both just 21 when, overcome by demons, they decided to kill themselves: One, Sandness, survived but with a face almost destroyed by a gunshot; the other man died.

Andy met Mardini, a plastic surgeon whose specialty is facial reconstruction. As a newcomer at Mayo, the doctor was on call Christmas Eve. Over the next few days, he reassured Sandness that he’d fix his face as best he could. “I just need you to be strong and patient,” he said. Sandness couldn’t bear to see himself, so he covered his hospital room mirror with a towel. He had no nose and no jaw.

Mardini and his team removed dead tissue and shattered bones, then connected facial bones with titanium plates and screws. They reconstructed his upper jaw with bone and muscle from the hip; they transferred bone and skin from a leg to fashion the lower jaw.

Over the next five years, Sandness made yearly visits to Mayo. In 2012 he received a life-changing call for face transplant programme.

Mardini and his team devoted more than 50 Saturdays over 3½ years to rehearsing the surgery, using sets of cadaver heads to transplant the face of one to the other. They used 3-D imaging and virtual surgery for the programme. Five months later, Mardini got a donor. In early June, Calen “Rudy” Ross fatally shot himself in the head.

Ross had been healthy and just 21, his heart, lungs, liver and kidneys could be donated. It took about 24 hours to procure the donor’s face and his entire face was rebuilt below his eyes, taking an additional 32 hours.