It has now been more than a year since 22-year-old Katie Stubblefield underwent a 31-hour operation to give her a new face. In the time since receiving her full-face transplant – adding her to the ranks of fewer than 25 such recipients worldwide – at the Cleveland Clinic, Katie has undergone three major revision surgeries and has been hard at work with physical, occupational, and speech therapy. The nerves connecting her brain to the newly introduced facial muscles are still growing, so she struggles to move many features. Her tongue and mouth, which lost so much of its native muscle and nerves when Katie attempted suicide by a rifle shot under the chin at age 18, are still not working well. She will need to take intensive regimens of immunosuppressant medications for the rest of her life, or until a breakthrough in anti-rejection science is made.
Yet overall, the young woman’s story is one of rousing success in the field of cutting-edge medicine and of the amazing human connections formed between physicians and patients. An in-depth look at the journey leading up to Katie’s face transplant, as well as her long road to recovery, is featured in National Geographic’s September issue and in a new documentary.
"I am able to touch my face now, and it feels amazing," Katie said in the video.
"You take it for granted, the different components of our faces – the bone, the tissue, the muscle, everything – but when it's gone, you recognize the big need,” her father, Robb Stubblefield, added. “Then when you receive a transplant, you're so thankful."
Five weeks after Katie nearly died from the gunshot wound, she arrived at the Cleveland Clinic in dire need of reconstructive surgery. A tissue graft from her abdomen had been performed by physicians in Memphis, Tennessee, where she was transferred after receiving emergency care in her home state of Mississippi, but this attempt to cover the gaping wound on her face had failed.
Plastic surgeon Dr Brian Gastman, the first clinic doctor to see Katie and the man who would go on to lead her transplant procedure, recalled to NatGeo that he was initially only concerned with stabilizing Katie, and he worried that even if that went to plan, there wouldn’t be enough tissue available for corrective surgeries due to her small size.
But over the course of the next two years, Gastman and his colleagues slowly rebuilt a new face and jaw using parts of her leg bone, Achilles tendon, reshaped thigh tissue, and titanium implants – utilizing a 3D printed model of Katie’s older sister’s face as a guide. Due to the level of damage, however, the medical team knew that the only way to give Katie anything close to a normal face would be a partial or full transplant. She and her family agreed, and Katie joined the transplant waiting list and started the intensive psychological evaluation necessary for approval.
Finally, in May 2017, they got word that a suitable match was available – donated from a 31-year-old woman who died from a drug overdose. The incredibly risky operation (at the time the mortality rate was 1 in 6) replaced nearly 100 percent of Katie’s facial tissue, including her eye sockets, upper and partial lower jaw and teeth, facial muscles and skin, part of the facial nerves, forehead, scalp, eyelids, nose, and cheeks.
Katie became the youngest person to receive a facial transplant in the United States and one of only 40 people to undergo such a procedure since the first partial face transplant was performed by a Spanish surgical team in 2005.