Since 2008, the United States has seen several landmark surgeries in face transplantation, giving people with severely deformed faces new lives through partially or totally different faces from donors.
Receiving a new face is anything but easy. The surgery requires long hours with many medical specialists collaborating to make it happen. The patient then has to adjust to the new face, biologically and psychologically.
There is a complex rehabilitation process where the patient learns how to eat, speak and make facial expressions again, said Dr. Maria Siemionow, director of plastic surgery research at the Cleveland Clinic.
"The surgical procedure itself of transplant is relatively standard," Siemionow said. "The major problem is the selection of the candidate -- who is and who is not the face transplant candidate."
For instance, doctors at the Cleveland Clinic would not consider someone who is totally blind because one of the requirements is to be able to exercise one's face in front of a mirror, "to make the face adjusted to the brain," she said about this still emerging field of surgery.
Here are the major publicly reported cases of facial transplants in the U.S.:
Surgery: December 2008
Connie Culp received the first near-total face transplant in the U.S. She was injured by a bullet in 2004 when her husband shot her. Culp was left partially blind, unable to smell and speak, and dependent on a surgical opening in her neck to breathe. (The world's first full-face transplant was done in Spain in 2010.)
A 22-hour operation at the Cleveland Clinic gave her most of a new face from a donor: Anna Kasper of Lakewood, Ohio.
Culp met the family of the donor in December 2010. She said around the same time that she was happy with the transformation.
"I can smell now," she told CNN in 2010. "I can eat steak, I can eat almost any solid foods -- so it's all getting better."
Siemionow, who led the surgery, said Thursday doctors at the hospital have been seeing Culp on a monthly basis since the transplant. She described Culp as "fully integrated back in her community." She is "a happy grandmother" with a boyfriend, and she is "very joyful."
Culp, now 49, is able to smile, frown and talk, and her speech is easily understood, Siemionow said. Before, Culp did not have a nose; now, she can breathe through it. Researchers have determined that Culp's brain accepts the new face, based on activity in key brain areas.
She is an advocate of organ donation and travels to deliver speeches about her experience.
"She's a very powerful personality to actually share her experience to help others," Siemionow said.
Surgery: April 2009
James Maki destroyed the entire core of his face when he fell onto the electrified third rail at a Boston subway station on June 30, 2005. He also suffered severe burns on his arms and hands. His breathing was impaired, and he couldn't speak coherently. Eating was also impossible; he was fed through a tube in his stomach.
A team of surgeons and other specialists worked for 17 hours at Boston's Brigham and Women's Hospital to give him a new face from a donor. Maki, who wore dentures before the accident, also got new teeth during the operation. But the teeth didn't take and eventually began to break.
He's now in the process of getting eight false teeth implanted into his mouth, and he'll have a new set of dentures, too.
"I'm going to have all my teeth," Maki, 63, said Thursday. "I'm looking forward to eating a lot of things -- like I have to eat stuff that's really soft. Once I get the teeth in, I can eat whatever. Cashews. Whatever I like."
He says he can't wait to eat a rib-eye steak.
Maki is also making facial expressions again. He says he has his good days and bad days. He's taken up the game of bridge at his local senior center.