Cameron Underwood received a new face on January 6, 2018. By the time his surgery ended, everything below Underwood’s eye sockets had been replaced with the face of organ donor William Fisher.
A face transplant is exactly what it sounds like—replacing the disfigured face of one person with the whole, undamaged face of a very recently deceased person.
A physician in France performed the first successful face transplant surgery in 2005. Since then, only 40 other such surgeries have been done around the world. Rodriguez has performed three of those surgeries, including Underwood’s.
Face transplants are an ideal setting to fuse medicine with the growing world of 3D printing and imaging. During Cameron Underwood’s surgery, everything from planning, printing the tools, and accurately aligning the face during the operation relies on the latest medical technology.
Building a digital model of a face
After suffering a self-inflicted gunshot wound, Underwood’s upper and lower jaw bones, gums, and all 32 teeth had to be replaced, as well as the roof and floor of his mouth, part of his tongue, the lower eyelids, cheeks, nose, and parts of the nasal passage.
Part of the normal 3D printing process involves taking a 3-dimensional digital model and converting it into slice files that the printer can then read and use to build the physical representation layer by layer, says Bryan Crutchfield, vice president and general manager for Materialise North America. Materialise realized they could reverse that process, using similar software to convert slice files, like those from a CT scanner, into 3-dimensional renderings.
After building the digital 3D model, Rodriguez could use it to determine how exactly he wanted to remove most of Underwood’s face and attach someone else’s. To assist with planning and the eventual surgery, Materialise printed a physical anatomical model of the face with an SLA printer that zaps a liquid resin with a UV laser over and over again to build the precise anatomical model, says Crutchfield.
Doing it all again—in just 24 hours
The biggest unknown in pretty much any transplant surgery is the availability of a donor organ. When a possible donor is identified, physicians have mere hours to determine if the organ is a true match for their patient and then move into surgery. If they wait too long, they won’t be able to keep the organ alive and the transplant will fail.
As luck would have it, as Rodriguez was examining Fisher and preparing for surgery, the ‘Bomb Cyclone’ hit New York City. Underwood barely made it to New York from his home in California. Two dedicated engineers from Materialise got in a car and drove the freshly printed cutting guides from Michigan to New York City. The entire process—from receiving the data to delivering the guides—took a mere 24 hours, says Bilkhu.
Getting down to business
On January 5, 2018, Rodriguez started the face transplant surgery. In the surgical suite, the surgeon used yet more cutting-edge imagery to ensure every cut and stitch happened in the exact, predetermined spot. Rodriguez pinned a device to Underwood’s skull that can project an image of the inside of his head to monitors in the operating room. He likens the system to the GPS in a car, only instead, he’s navigating inside someone’s head.
“I’d like to say that there have been so many amazing advances in surgery, I’m living proof of that,” Cameron Underwood said at a press conference last month when he revealed his new face to the world. “But it only happens because of special people like Will and his family. Thank you.”