Hero firefighter who saved woman's life undergoes most extensive full face transplant

Patrick Hardison has had an incredible second chance at life after being left badly disfigured, receiving what scientists have called the most extensive face transplant.

In 2001 the father of three entered a burning house to save a woman before the roof caved in from around him, leaving him with third-degree burns on his head, neck and upper torso.

The injuries meant he endured 71 surgeries.

In August the 41-year-old, who served seven years as a volunteer firefighter, received the face transplant covering his skull and much of his neck after a donor died of head injuries from a biking accident in New York.

Mr Hardison is still undergoing physical therapy in hospital but plans to return home to Senatobia, Mississippi, in time for Thanksgiving.

The surgery has paved the way for him to regain normal vision, and in an interview last week he said that will let him accomplish a major goal: "I'll start driving again."

More than two dozen face transplants have been performed worldwide since the first one in France in 2005. Dr. Eduardo Rodriguez, who led the surgical team that did Hardison's transplant and recently wrote a review of the field, said Hardison's is by far the most extensive performed successfully in terms of the amount of tissue transferred.

After the right donor came along, the surgery began on August 14 and lasted 26 hours and left no scars on Mr Hardison's new face because the seam of the transplanted tissue runs down the back of his skull.

The transplant extends from the top of the head, over Mr Hardison's skull and down to the collarbones in front; in back, it reaches far enough down that only a tiny patch of Hardison's original hair remains — it's colour matched by the dark blond hair growing on his new scalp.

The transplant includes both ears.

The firefighter spent two months at a Memphis, Tennessee, burn centre where doctors used a layer of skin from his legs to cover his wounded head, but he had lost his ears, lips, most of his nose and virtually all of his eyelid tissue.

Since he could not blink, doctors used skin grafts to reinforce what remained of his eyelids and sewed them nearly shut to protect his eyes, leaving him with only pinhole vision.

"I was almost totally blind," he recalled. "I could see just a little bit."

His face was "one huge scar," Rodriguez said.

Mr Hardison still went to baseball games and did other things outside, although people stared.

He playfully told curious children that he had fought a bear.

Still, he said, life was hard.

Eventually a church friend of his wrote to Rodriguez, who had performed a 2012 face transplant at the University of Maryland Medical Centre.

The doctor said he would try to help, and in August 2014 Hardison was placed on a waiting list.

"We were looking for the ideal donor," one who matched the Mr Hardison on biological traits to minimise the risk of his body's rejecting the new tissue, as well as things like skin and hair color, said Dr. Rodriguez, who by then had moved to NYU Langone.

The ideal donor was 26-year-old New York artist and competitive bicyclist David P. Rodebaugh.

The long-haired, bearded man was not wearing a helmet when he was riding home on his bicycle from his last day at work on July 22 when a pedestrian walked into his path causing him to slam into the pavement.

The cyclist fell into a coma and never woke up.

Rodebaugh was then identified as a potential donor by LiveOnNY, the nonprofit organisation that seeks transplant organs and tissue in the New York City area.

His mother gave permission to use his face, noting that Rodebaugh had always wanted to be a firefighter, said LiveOnNY president Helen Irving.

The hospital paid for the transplant operation, which included attaching four bone segments to Hardison's skull, as anchors to prevent the face from drooping.

Now, three months later, the lower part of his face remains swollen, but Rodriguez said that will go away in a few months. With his new eyelids and more surgery, he's expected to regain a normal field of vision for the first time in more than a decade.

Of the 30 people who have had face transplants, up to five have died from rejection, New York Magazine stated.

Mr Hardison will have to continuing taking medications to prevent his body from rejecting the transplant.

Eventually, "a casual observer will not notice anything that is odd" in Hardison's new face, which will blend features of his original face and the donor's, Rodriguez said.

Hardison said his new face has already made a difference when he goes outside.

"I used to get stared at all the time, but now I'm just an average guy," he said.

He's been told he can't return to firefighting because of insurance concerns, but he has another plan: motivational speaking or something similar, perhaps for wounded veterans.

His message? "Just how there is hope."