How Two Separate Tragedies Gave One Man a New Face

In June 2016, Mayo Clinic performed its first-ever face transplant, and the story behind it — like the procedure — is anything but ordinary.

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In 2006, 21-year-old Andy Sandness placed a rifle under his chin and pulled the trigger. The shot destroyed most of his face — his jaw and nose were gone; his mouth shattered — but Sandness survived.

After a nearly five-month hospital stay and eight reconstructive surgeries, Sandness went back home to Newcastle, Wyoming, where he worked as an electrician's apprentice. Because of his disfigurement, Sandness chose to keep to himself, often avoiding eye contact with children so he wouldn't scare them and retreating to nearby hills for hunting, fishing, and solitude.

Sandness on June 10, 2016, as he waits for his face transplant procedure at Mayo Clinic in Rochester, Minnesota.
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Then, in 2012, Sandness's surgeon, Dr. Samir Mardini, called with good news: Mayo Clinic, where Mardini worked, was going to launch a face transplant program — and Sandness was an ideal patient.

"When you look like I looked and you function like I functioned, every little bit of hope that you have, you just jump on it," Sandness told the Associated Press. "And this was the surgery that was going to take me back to normal."

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But before Sandness could be confirmed as a viable transplant recipient, he had to undergo a psychiatric evaluation to make sure he was not only physically, but mentally, ready for the procedure. The doctors' primary concern: The suicide attempt that resulted in his disfigurement.

The evaluation results were largely in Sandness's favor: It had been nearly a decade since the shooting, he had a strong family support system, and his rapport with Mardini showed resilience and motivation to improve his life despite his past harships. After much consideration, he was deemed ready for the procedure.

The Life-Changing Decision of a Grieving Widow

In June 2016, five months after Sandness was added to the United Network for Organ Sharing, 21-year-old Calen "Rudy" Ross of Windom, Minnesota, shot himself in the head.

Rudy died as a result of his injuries, but his status as an organ donor made it possible for him to improve the lives of six different people — Sandness was one.

The donation of Rudy's liver, heart, kidney, pancreas, and lung were easy decisions for his eight-month-pregnant widow, 19-year-old Lilly Ross. The face transplant, however, took a little more convincing.

"I was leery at first," Lilly said in an interview with the Daily Mail. She was worried that Sandness would look like her deceased husband. But once the doctors assured her that would not be the case, Lilly gave her consent.

After years of waiting and preparation, Dr. Mardini, his 60-person team, and Sandness were ready for the face transplant — the first for Mayo Clinic. The marathon surgery began on June 10, 2016 and lasted a total of 56 hours: 24 hours to remove Rudy's face, 32 hours to attach it to Sandness.

Each step of the procedure had to be perfectly orchestrated and precision was key: The medical team mapped the nerves on each man's face, carefully matching them with their corresponding movements — one nerve could account for 20 percent eyelid movement and 80 percent smile; another could work to close the mouth. Once the skin and nerves were removed from Rudy's face, they had to then be perfectly matched up with the nerves on Sandness' face. The blood vessels and bones from Rudy's face had to match up with Sandness' as well. When the team was finished, Sandness had Rudy's nose, cheeks, mouth, lips, jaw, chin, and even his teeth.

Sandness in January 2017.

Following the surgery, Sandness wasn't allowed to look at himself in the mirror for three weeks; when he finally saw himself for the first time, he scrawled four words in a notebook: "Far exceeded my expectation."

The same is true for Lilly, whose husband's death left a legacy — not only for the lives he changed, but for his son, Leonard, as well.

"I just wanted to show him, later, down the road, all the people his dad saved," Lilly said.

[h/t Daily Mail]

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