Two-and-a-half years ago, Andy Sandness was wheeled into an operating room at Mayo Clinic's Rochester campus for a 56-hour marathon surgery to give him a face transplant — the first performed at Mayo Clinic. Now he's living the life he hoped for.
Since the surgery, Andy has been able to return to typical daily activities, such as eating and drinking normally — things that weren't possible for him before. "Just going into a restaurant or stores, I feel normal," Andy says. "Nobody stares like they used to. I just sit down. I can talk."
And he appreciates little things many other people take for granted. "What I like is just being able to smile and being able to have the lip movement, and being able to kiss," he says.
A few years ago, Andy didn't know if it would ever be possible for him to enjoy those small pleasures. But he was determined to try. "I made a huge list of all my goals of what I wanted," Andy says. "I wanted function more than anything with the aesthetic looks."
They were ambitious goals, considering that the results of face transplants can be unpredictable.
To make it more likely that Andy would be able to achieve the function he wanted after the transplant took meticulous preparation. Mayo Clinic surgeon Samir Mardini, M.D. led a team of dozens that performed Sandness' face transplant. They spent more than 50 Saturdays over a three-year period planning and practicing every step of the surgery with surgeons, nurses, surgical technicians and anesthesiologists.
Key to their preparation was practicing the exacting nerve surgery that would be required as part of Andy's face transplant.
"We identified on the donor all the facial nerve branches supplying the area of the face that was transplanted," Dr. Mardini says. "We took pictures. We videotaped. We studied what every little branch of those nerves did for the face. And we did the same thing on Andy."
Connecting all of the nerves during the transplant surgery was a tedious but crucial process.
"When we came to connect the nerves together, we had to make sure that every nerve branch matched the perfect nerve branch from the donor and the recipient, so that the function is exactly what Andy will try to do when he's doing his daily life," Dr. Mardini says. "So if he wants to smile, he thinks about smiling. It goes from his nerve for the smile to the donor nerve for smile, and it creates a smile."
Soon after the surgery, when his scars were more noticeable and the nerves still were regenerating, Andy was in line at a grocery store when someone asked him what had happened to his face.
"He's like, 'Did you get in a car wreck?' Like no, man, it's a little bigger than that," Andy recalls saying during the exchange. It was a significant moment for Andy, though, because he could tell that it never occurred to the man that the face he was asking about didn't always belong to Andy.
"That was our goal," Dr. Mardini says. "Success for us was measured in multiple fronts. But ultimately, success is Andy walking into a store, not being noticed as someone abnormal in any way, talking to the person at the counter. They talk to him back. They don't think twice about him. And he moves on with his day. That's a success to us, and that's what we were able to achieve in Andy's case."
It's what Andy always wanted: to be just another face in the crowd. And the payoff from those long hours in the operating room continues to grow.
"There's no part of me that's uncomfortable anymore. There's no situation that I don't want to be in anymore," Andy says. "It's part of me. It's my face."
Watch a video about Mayo Clinic's first face transplant: