For nearly ten years, Derek Pfaff lived without the ability to eat normally, blink, or recognize the face he once knew. In 2014, the then-19-year-old college student from Harbor Beach, Michigan, survived a suicide attempt that left most of his face severely damaged by a self-inflicted gunshot wound. When he awoke in the hospital, he had no memory of the incident and initially believed he had been in a car accident.

Over the following decade, Derek underwent 58 reconstructive surgeries. Despite the extensive efforts of medical teams, significant functional limitations remained. He could not chew or swallow solid food properly, struggled to speak and breathe, lacked a functional nose, and was unable to blink. Doctors eventually determined that a face transplant offered the best remaining option for restoring both appearance and essential functions.

In February 2024, a multidisciplinary team at Mayo Clinic in Rochester, Minnesota, performed one of the most complex procedures in the institution’s history. The surgery lasted more than 50 hours (some accounts place it near 60 hours) and involved over 80 medical professionals, including surgeons, anesthesiologists, nurses, and specialists. Led by Dr. Samir Mardini, surgical director of Mayo Clinic’s Reconstructive Transplant Program, the operation replaced and reconstructed approximately 85% of Derek’s face. This included the nose, upper and lower jaws with teeth, eyelids, portions of the forehead, cheek structures, facial muscles, nerves, skin of the face and neck, and related tissues.

The transplant restored critical abilities. Derek could once again blink, smile, swallow, and breathe through his nose. About a month after the procedure—exactly ten years to the day after his injury—he saw his new face for the first time. “After all that work, I look like a person again. It was incredible,” he later reflected.

Today, Derek, now in his early thirties, emphasizes the gift of a second chance. He hopes to use his experience to encourage others facing mental health struggles to seek help. He survived a single devastating night and then spent a decade rebuilding what it had taken away, ultimately receiving a life-giving procedure that restored not only function but also a sense of identity and possibility.

This case stands among the relatively small number of successful face transplants performed worldwide (slightly more than 50 in the past two decades) and represents Mayo Clinic’s second such procedure. It highlights both the extraordinary technical advances in reconstructive transplant surgery and the profound personal resilience required to endure years of recovery.

Sources

• Mayo Clinic News Network official announcements and patient story (November 2024).
• CNN, Star Tribune, MLive, and Newsweek reports detailing the 2014 injury, series of reconstructive surgeries, February 2024 transplant, and postoperative outcomes.
• Statements from Derek Pfaff, his parents, and lead surgeon Dr. Samir Mardini.