Mayo Clinic surgeons perform complete facial reconstruction with help of 3D printing

Eight months after his surgery, and ten years on from his suicide attempt, Andy Sandness is relishing a return to his normal life.

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Surgeons at the Mayo Clinic in Minnesota have performed a complete facial reconstruction of a 32-year-old male, thanks in part to 3D printing.

Andy Sandness was in his early twenties when he attempted to take his own life with a high-powered rifle. Though he failed in his attempt, one which he has regretted ever since, Andy had to live with severe facial injuries for ten years.

Prior to the surgery, Andy reflected on that near-fatal incident: “You know what, I was stupid, and I made the wrong choice. Now I’m paying for it for the rest of my life.”

Battling depression before and since the incident, Andy’s fortunes changed when the Mayo Clinic decided to tackle what would be an incredibly complex procedure. Only a few dozen face transplants have ever been attempted. None, perhaps, were as complicated and challenging as this one, which involved work on nearly every tissue below Andy’s eyes.

Altogether, the process would take over 50 hours, and even more time would be spent meticulously planning in the months and years beforehand. 3D modelling and 3D printing techniques allowed the surgical team to plan every step of the process, ensuring each phase would be safe. Such is the complexity of a full facial reconstruction, Andy was made aware of the risks involved prior to his commitment to undergoing surgery. Using 3D technology, the surgeons gained a sense of proactivity, allowing them to negotiate potential dangers way in advance, and ultimately enabling them to achieve the perfect fit for Andy’s face.  

“Using this technology of 3D modelling, printing, a virtual surgical planning is extremely beneficial,” said Dr Samir Mardini M.D., a Surgical Director at the Obaid Center for Reconstructive Transplant Surgery, Mayo Clinic, who led the procedure. “They would have cutting guides for us that we could clip on the bones, that would give us the exact location of the cut, exact angle of the cut, so when we took the donors face and put it on the recipient it would fit perfectly.”

A face transplantation involves a combination of a number of other, smaller procedures, including eyelid surgery, jaw surgery and facial nerve surgery. The team operating on Andy comprised of nine surgeons, and 40 operating room staff, scrub nurses, circulating nurses and clinical perfusionists. This team were tasked with rebuilding Andy’s entire lower face, including the nose, jaw bones, zygomatic bodies, teeth and the skin from the ears down to the chin.

Three weeks after the completion of the surgery, Andy, still unable to speak, caught his first glimpse of his new face in a mirror. Still healing, Andy wrote a note for Dr Mardini, which read: ‘It far-exceeded my expectations.’

Earlier this month, eight months after the surgery, Andy spoke, not wrote, in more detail about his impression of the reconstruction, his gratitude towards the donor family, and a return to normalcy.

“I was absolutely blown away by the result. I just feel like a normal person, walking around outside, going to the shopping malls, nobody asks any questions, nobody stares. Now with this transplant I just feel more comfortable in doing these things.

“I’m now able to chew and eat normal food, and the nerve sensation is slowly improving too. My confidence has improved, and I’m feeling great – and grateful.

“Without the donor, and the donor family, none of this is possible. I can’t say thanks enough to those people, what they did, what they gave me. I’m just looking forward to getting back out into the world and doing things I missed out on. I missed out on ten years of my life. I’m really excited.”

The process of reconstructing Andy’s face was an arduous and complex journey for both patient and surgeons alike. Mayo Clinic is delighted a man who has battled valiantly on two fronts over the last ten years is now more confident and comfortable in his own skin.

“Mayo Clinic has a long history of specialised teams of experts providing complex care to patients who need hope and healing,” finished Dr Mardini. “Andy has been our patient for ten years. He has worked so hard to prepare for this, and during his entire recovery period, he has been strong, gracious and determined. Andy is an amazing person and so well-deserving of this gift.”

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