But Whitman and her family realized, "After somebody just died and gave you a heart, how could you say no?"
Maki was taken into the operating room four days later.
Dr. Pomahac likened the night of Maki's face transplant operation to a big concert as he coordinated and directed how best to perform the surgery. Multiple specialists had to be consulted or brought in -- surgeons, anesthesiologists, immunotherapists, nurses, residents, physical therapists and technicians.
A face transplant is an incredibly risky procedure. Aside from the dangers of the surgery itself, there is the possibility that the donor blood vessels will not connect well with the recipient's tissue and the patient's body could reject the face. Even if all goes well, Maki will have to take medications to fight off rejection and infection for the rest of his life.
"This is nothing like, you know, science fiction, [the movie] 'Face-Off' sort of thing. It's nothing like that at all," said Dr. Julian Pribaz, one of the plastic surgeons who operated on Maki. "This is real life."
Having only previously practiced on cadavers, Pomahac and his team tried to prepare as best they could as they headed into the unknown. At the time, only one other face transplant had ever been done in the U.S., and at 1 a.m., April 9, 2009, the second face transplant in the nation began.
Two operating room teams, one for the donor and one for the recipient, started simultaneously, identifying all the muscles and nerves.
After about seven hours, the facial parts of the donor were packed into an ice cooler and carried across the hallway to Maki's operating room, where Pomahac and Pribaz began to marry the tissues and vessels together under a microscope.
The entire surgery would not end until 4 p.m. the following day.
Maki woke up groggy in the intensive care unit. His daughter Jessica Maki, a senior at Northeastern University, and his wife, Cynthia Maki, came to see him and were elated over his new face.
"Compared to the no-face he had before, I mean, it's amazing," Jessica Maki said. "It surprisingly looks more like him than I thought it would."
She admitted it had been hard to go out in public with her father.
"Life without a face is not a life," she said. "It's just emotionally and psychologically and physically, you can't participate in life. As superficial as that may sound, definitely, it will be much easier with a face."
Maki, too, was delighted with the results.
"I've got a nose," he told Pomahac. "I can see myself in this picture."
He thanked his surgeon for a job well done.
To date, a dozen face transplants have been performed, some involving more facial tissue than others, in France, Spain, the U.S. and China. Maki knew his new outlook on life was possible because of those who paved the way before him.
Isabelle Dinoire from France became the successful first face transplant recipient in 2005 after she was mauled by her dog. About a month after his surgery, Maki got the chance to meet her when she was visiting the U.S.
Using a translator, Maki told Dinoire, "I'm glad to see you went through it all right. I'm in the process of trying to do that now."
Maki was about to get another emotional visit. On the morning of May 19, 2009, Susan Whitman arranged to meet the man who now had her husband's face.