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A 30-year-old Michigan man can smell, swallow, blink and smile for the first time in a decade thanks to a face transplant at Mayo Clinic.
In the last 20 years, just a little more than 50 face transplants have been performed worldwide. This is the second face transplant completed at Mayo Clinic.
For Derek Pfaff, the transformational surgery has been life-changing.
Journalists: Broadcast-quality video (6:32) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.
On the shore of Lake Huron in a small town with just one traffic light, everybody knows everybody in Harbor Beach, Michigan. A decade ago, the face of Derek Pfaff was well-known in this tight-knit community.
"He was kind of that hometown hero," says Lisa Pfaff, Derek's mother.
The son of Jerry and Lisa Pfaff, Derek was a straight-A student and captain and star running back on the school's only state championship football team.
On the night of March 5, 2014, Derek, then 19, was home from college on spring break when he decided to take his own life.
"I looked across, and the gun cabinet was open … I just … my heart dropped," says Jerry Pfaff, Derek's father.
"He does not remember getting the gun. He does not remember going outside. He does not remember shooting himself," says Lisa. "We met with the doctors, and they told us that there was no way Derek was going to make it."
But Derek did survive. "It's a miracle he lived," Lisa says.
However, most of his face was gone.
"I should have died that night. I'm thankful to be alive," Derek says.
Thankful to be alive, but after 10 years and 58 reconstructive surgeries, what remains of Derek's face is unrecognizable. He has only one eye and is unable to blink. He struggles with speaking and breathing normally, and no longer has a sense of smell. He can't chew or swallow food, and uses a feeding tube to eat.
"After my last surgery, the doctor told my parents that there's nothing more he could do except refer us to a place to get a face transplant," Derek says.
Ultimately, that place would be Mayo Clinic in Rochester, Minnesota.
"The thought of this surgery is our ray of hope," Lisa says.
"Life-changing for him," Jerry says.
It's a second chance at life for Derek.
"The heart is a lifesaving operation. The kidney, for the most part, is a lifesaving operation. With facial transplantation, it's a life-giving operation. You can live without it, but you're missing out on life," says Dr. Samir Mardini, surgical director of Mayo Clinic's Reconstructive Transplant Program. "Face transplant is a rare surgery. There are only a few teams around the world that are doing them."
Derek's surgery is Mayo Clinic's second face transplant and its most complex and extensive procedure to date. A face transplant replaces all or part of the face with donor tissue. Dr. Mardini estimates 85% of Derek's face needed to be replaced.
"In Derek's case, the donor tissue included part of the forehead, the upper and lower eyelids on the right side, the nose, the mouth, the upper and lower jaws — including the teeth — as well as all of the skin, muscles and nerves of the entire face and neck," says Dr. Mardini.
The most meticulous part of this complex surgery is reconnecting the many small nerves between Derek and the donor to ensure function, like eating, blinking and even smiling, is restored.
In extensive preparation for Derek's surgery, the face transplant team spent nearly nine months, including many weekends, rehearsing the procedure. Detailed scans of the face allowed the team to practice the surgery virtually. The latest technology in medical modeling and 3D printing also played a vital role in the planning and execution of the surgery.
"The restorative nature of the facial transplant makes it very complex," says Dr. Mardini.
In February 2024, a donor becomes available. Six surgeons and a multidisciplinary medical staff numbering more than 80 complete a surgical marathon lasting nearly two and a half days.
"We're trying to give Derek back functions he was missing for 10 years," says Dr. Mardini.
Still healing nearly a month after surgery — and 10 years to the day of his suicide attempt — Derek gets the first glimpse of his new face. In the months to follow, Derek has additional surgeries to refine his appearance, improve his tongue and eyelid function, and ensure the connection of nerves is working properly.
"This is not an aesthetic operation, although the side benefits of it are hugely beneficial for the aesthetics of the patient," says Dr. Mardini. "Derek is looking to be normal. He's looking to walk on the street and not have anyone notice anything on him."
As he approaches a new year in 2025, Derek is just another face in the crowd now — with a new smile.
"It makes my heart so full to see him smile and happy and just be a normal person again," Lisa says.
"It's been 10 years since you've seen a nose, lips and teeth on your son — just totally amazing, a miracle," Jerry says.
"It wasn't just Derek's face that was given. It was his other organs as well. So there were multiple recipients tied to that one donor, and that is the greatest gift that someone can make the courage and the decision to do," Lisa says.
Because of that donor's gift, Derek, now 30 years old, is ready to start the next chapter in his life.
"One day, meet someone, start a family," Derek says.
And he has found purpose as a public speaker for suicide prevention.
"Talk to someone. Tell them how you're feeling," Derek says.
"He's received so many letters that it's kind of like his calling now to continue to impact people and share," Lisa says.
"Hearing their stories and how I helped them, makes me feel pretty good," Derek says. "I lived for a reason. I want to help others anyway I can."
Related content:
- Mayo Clinic performs successful face transplant, restoring vital functions for Michigan man
- Transforming a life: Mayo Clinic announces its first face transplant
- Mayo’s first face transplant patient meets donor’s family
