Inside a 26-year-old man's history-making face transplant

His nose, jaw, and teeth were destroyed by a self-inflicted gunshot wound during Cam's battle with depression. Now, the California man can once again smile, eat, and speak thanks to a 25-hour face transplant.

It was less than two years ago that 26-year-old Cameron Underwood woke up missing most of his face.

His nose, jaw, and teeth were destroyed by a self-inflicted gunshot wound during Cam's battle with depression. Now, the California man can once again smile, eat, and speak thanks to a 25-hour face transplant.

It took more than 100 medical professionals at New York University Langone Medical Center to pull off the transformative surgery that restored Cam's face. Led by Dr. Eduardo D. Rodriguez, the team transferred the face of a recently deceased 23-year-old Manhattan student onto Underwood's skull.

Underwood's medical team announced the success of the face transplant, which took place last January, at a press conference on Thursday.

"It’s really remarkable to be a part of this," Rodriguez said at the conference. "They finally get to see their child whole again," he said referring to Underwood's parents, Beverly Bailey-Potter and Randy Underwood.

 

Although this is the second face transplant Rodriguez has performed at NYU, this surgery is unique in that Underwood waited only 18 months after his injury to receive a face transplant. Many people suffer for years, according to Rodriguez. Underwood also spent less time in the hospital and in rehabilitation after his surgery than the first face transplant performed at NYU Langone. This is the second face transplant at NYU and one of roughly 40 performed worldwide.

Growing up in Yuba City, California (about 40 miles north of Sacrament0), Cam spent his weekends fishing, hunting and skiing with his older siblings Julie, Aaron, and Brad. As a teen, Cam struggled with depression, his family explained to People. In his 20s, Cam used alcohol to self-medicate during these depressive episodes.

“I saw that he was struggling, he was unhappy,” Beverly told the magazine. “But I never thought he would harm himself.”

On June 27, 2016, Cam turned to alcohol during a particularly rough time and attempted to end his life.

He was taken to the UC Davis Medical Center and put into a medically induced coma. When he woke up, Cam didn't even remember the incident and was shocked at what he'd done, the magazine reported.

 

He remained in the hospital for five months and underwent three skin grafts to salvage what they could of his face. During this time, Beverly never left Cam's side. The dutiful mom even lived in a trailer in the hospital parking lot.

Although Cam was finally discharged from the hospital in December 2016, he couldn't enjoy simply daily activities. Cam no longer experienced the crunch of a chip since eating solid foods was challenging. Smiling was out, and communicating with others was particularly challenging. He often resorted to writing messages over speaking. And the once active outdoorsman could no longer go golfing or skiing with his family.

"His life was on pause," Rodriguez says.

However, the family hoped that a face transplant could set Cam in motion once again. But it wasn't until Beverly picked up a copy of People magazine at the grocery store that Cam's future looked brighter. Inside was an article about Rodriguez's success performing face transplants. Beverly was inspired by the story and knew he was the doctor for Cam.

In February 2017, Rodriguez received an email from Beverly.

"Cam very much wants to move past this horrific incident," she wrote. "We will go anywhere and do whatever it takes to help Cam achieve this."

In a video shown at the conference, Cam said, "It was a low time in my life. We all do things that are not ideal."

Determined to move forward, Cam trekked 2,800 miles for an evaluation with Rodriguez in March 2017–a meeting that almost didn't happen thanks to a snowstorm.

 

After the initial evaluation, Rodriguez traveled to California and got to know Cam, his family, as well as Cam's physicians to ensure his patient had a strong support system.

"It’s a very tedious and methodical evaluation process," Rodriguez said.

Cam also received counseling from a clinical psychologist, who he still sees, which is important for transplant recipients to ensure they're able to cope with the changes.

In July 2017, Cam was added to the waiting list to receive a donor organ. LiveOnNY, an organ recovery organization for the New York metropolitan area, led the search. During the wait, Cam went to the gym with his brother since patients need to be physically fit to undergo the operation.

No one knew how long Cam would be waiting to receive a new face. Rodriguez spoke to Helen Irving, president and chief executive officer of LiveOnNY, daily about potential matches.

"It’s like finding a needle in the haystack," Rodriguez explained. Face donors and recipients must match in blood type, antibody, skin tone, hair color, and facial bone structure,according to NYU.

Cam didn't have to wait long for his ideal match: 23-year-old William Fisher, a Manhattan resident and student at Johns HopkinsUniversity. Will was a registered organ donor who spoke to his family about his desire to help others after death.

On January 5, 2018, Rodriguez and his team performed the remarkable surgeries. In one operating room, medical staff removed Will's face while doctors prepared Cam to receive the special gift.

Leading up to that fateful day, Rodriguez and his team performed seven rehearsal operations to ensure they were prepared.

"By the third or fourth time you really feel like it’s second nature," he said to MensHealth.com in an interview after the press conference.

The transplant was one of the most technologically advanced operations of its kind. The team used 3D models to ensure the donor face was precisely fitted to Cam's. Will also received a 3D printed mask of his own face as a replacement.

"There are no do overs," Rodriguez said. "When you remove the face and you’re looking at the back of his throat, failure is not an option."

The operation went seamlessly, and Cam was discharged from the hospital earlier than expected. He describes seeing his face for the first time as "overwhelming" because it seemed like he transformed overnight.

Despite his quick recovery, Cam still faces many challenges since he doesn't feel sensation. Nerves take a long time to grow back, so it will be a while before Cam regains fine motor skills, Rodriguez explains.

"You go home and try to take a drink and it’s just all over [the place]," says Cam. "You don’t really know, are you smiling straight? "

He likens the experience to receiving Novocain at the dentist.

Cam has since returned to the adventurous lifestyle he enjoyed prior to the incident. In fact, he went skydiving for his brother's birthday just a couple of months after his surgery.

But the ability to speak has been the biggest change in Cam's life.

"I used to hate having to go somewhere where I was going to have to explain something. I knew I had to end up writing it because nobody was understanding," he explained to MensHealth.com.

He misses his job as a welder and machinist but should be back to work in a couple of months.

"I think I'm ready for that," he said.

As for his old face, Cam doesn't even miss previous identity.

"I don’t see the old me," he said. "I see this Cam." 

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