Face Transplant Surgery Gives 41-Year-Old Former Firefighter a New 26-Year-Old Face

— -- Being a volunteer firefighter meant everything to Pat Hardison, but when an accident during a rescue mission left his face severely burned, he thought he would never be the same again.

“It was terrible,” Hardison, 41, told “Nightline." “I mean, I left home one day a normal dad, leaving to go to work, just a blonde-haired, blue-eyed-- that had everything going, I thought, and just like that everything changed drastically.”

But 14 years later, Hardison got the call to come to NYU Langone Medical Center in New York City, where a surgical team, led by renown reconstructive surgeon Dr. Eduardo Rodriguez, who is the chair of the hospital’s Wyss Department of Plastic Surgery, would prepare him for the most extensive face transplant ever performed.

It was a procedure so extreme and so risky that his doctors warned him he only had a 50-50 chance of surviving it. But it was a risk he was willing to take for the chance to get his life back and feel normal again.

“I prayed daily that there would be a miracle to help me get through this, and you know, it’s all in God’s timing,” Hardison said.

In 2001, Hardison and his second wife Chrissi were raising their three children in his hometown of Senatobia, Mississippi. At 27, he was a charming, successful salesman who ran the family tire business, but his real passion was working with the local volunteer fire department where he was a captain.

“It was my way of life, that was what I did,” he said. “I didn’t do it to make a living, I did it because I loved it... at this department it’s different. It’s not like a fire department that volunteers, we’re a brotherhood.”

It was a brotherhood made up of the kind of men willing to rush headlong into a burning home, which is exactly what Hardison did on Sept. 5, 2001.

“It was just a normal day,” he said. “Just like every other fire... we went in looking for a lady.”

Hardison and his fellow firefighters got the call to respond to a house fire, and when they arrived, he entered the building with three other firefighters. He doesn’t remember much of what happened next, except the ceiling collapsing around him.

“[My mask] was melting to my face,” Hardison said. “My hose [was] already melted.”

He pulled the mask off, held his breath and closed his eyes, which doctors say saved his throat and lungs from smoke inhalation damage and from losing his vision. He doesn’t remember exactly how he managed to escape the inferno but by the time he got out, he was unrecognizable.

“There was nothing left of his face to tell you who he was,” said Bricky Cole, one of Hardison’s friends and another volunteer firefighter on-scene that day.

His friends rushed to save Hardison’s life, but they didn’t realize who they were working on until he was being loaded into an ambulance.

“He pulled me down over his face… and said, ‘you got to take care of Chrissi and the kids,’ and my world shut down,” said Cole. “You never think it’s going to happen to you or yours. We closed the door on that ambulance and I figured it was the last time I would ever see him alive.”

Hardison spent the next 63 days at the hospital recovering from the burns that took his scalp, ears, eyelids, nose and lips. His entire face was gone.

The cycle of surgery and painful recovery took a heavy toll on Hardison and his family, including Chrissi, who was caring for him at home. Even though they had two more kids after the accident, their marriage was strained, and for a time, Hardison became withdrawn and was addicted to pain medication. After 10 years of marriage, he and Chrissi divorced.

“It was hard for me to tell him, to say something to him, and it was even harder for him to hear it and accept it as the truth… ‘you’ve got to hit rock bottom, before you see up again,’” Travis McDonald said.

Without eyelids, Hardison was also slowly losing his vision. His eye doctor told him he would eventually go blind. Hardison started to consider an option that had only recently been demonstrated to be possible: a face transplant.

At the urging of a friend, Hardison sent his medical records to Dr. Eduardo Rodriguez, a pioneering reconstructive surgeon who had just completed the most extensive face transplant ever performed to date, replacing the face, jaw and tongue of a man severely disfigured by a shotgun blast. The 2012 surgery had been a success and Rodriguez was looking for his next patient.

“Patient selection is probably the most important factor for this operation,” Rodriguez said.

In 2012, Rodriguez and his team began the process of vetting not just Hardison, but his family, friends and neighbors in Mississippi. Rodriguez wanted to make sure that Hardison fully understood the surgical risks, both the physical and psychological recovery, and that there was a possibility his body could reject the transplant and he could die. He also wanted to make sure Hardison was of good character and would be compliant with his post-surgery responsibilities, including medical appointments and daily medicine intake.

To move forward, they needed a donor, one that would fit very specific criteria. Not only were they looking for a donor that matched Hardison’s skin color, hair color and blood type, but the skeletal structure also had to be similar.

“The blood type obviously has to match,” Rodriguez said. “We didn't want any viruses. We're not looking for any patient that has significant exposures, I.V. drug use and the like. We also look at tattoos, not so much that tattoos are bad, but individuals that get numerous tattoos, we're concerned about contamination of any form. We're looking for a patient that has not had any malignancy and no facial injuries. We're looking at skeletal measurements we want them to match skeletally. We look at specific distances of their eyes or nose or mouth, the lips, so we're very specific in a face transplant.”

Hardison was placed on New York’s transplant donor list in August 2014, and Rodriguez and his team began working closely with LiveOnNY, the organ procurement non-profit organization that matches organ donors with patients in and around New York City.

With such a specific set of criteria, LiveOnNY president and CEO Helen Irving said it was the hardest search the organization had ever conducted.

“This is possibly the most difficult search that we've ever done,” Irving said. “For sure it would have been made easier if more people signed up on the registry and more people said yes to donation, but in this particular instance we are looking for what I call a specific needle in a specific haystack.”

After a couple of leads fell through, the wait for a donor started taking its toll on Hardison.

“It’s just a day-by-day thing, get up every morning and think, 'is today the day?' And the next day is the same thing, that’s just how it is,” he said.

Months went by without a match, and Hardison struggled with waiting.

“I don’t know how many times he’s thought about it, but I know he’s thought about giving up at least once,” said his friend Travis McDonald. “And he got to the point where he told me he didn’t know if he wanted to keep living and we talked about it. He’s got kids to live for and the main thing he was worried about was his sight and not being able to see them anymore. I said, ‘well at least you can hold them.’”

Then, in July 2015, Hardison finally got the call he had hoped for, but it meant tragedy for another family.

David Rodebaugh, or Dave to his friends, loved bikes. He worked as a bike mechanic and was an accomplished BMX rider. When he moved to Brooklyn from Ohio a few years ago, he found a new family in the bike messenger community and with a group who call themselves the “Lock Foot Posi."

“It's like the old Christmas movie, the old Rudolph movie, where there's the Land of Misfit Toys,” said Al Lopez, who owns a bike messenger company called Cannonball Couriers and is one of Rodebaugh’s best friends. “And we're all kind of like misfits from somewhere. Wherever we came from for whatever reason we've united over bikes… It doesn't really matter what you wear or how you ride you know like if you're like. If you're down and you're like on the bike and you're one of us.”

His friends said there wasn’t a trick Rodebaugh wouldn’t try or a bike he couldn’t fix, and he even won the Red Bull-sponsored Brooklyn MiniDrome cycling competition in 2014.

“Dave was a free spirit for sure and he loved what he loved,” Lopez said. “He loved bikes. He loved to go fast. He loved his friends, he loved this family. He loved adventure like, that was, that was Dave.”

But the bike he loved riding eventually claimed his life.

In July 2015, Rodebaugh was riding without a helmet in Brooklyn when he crashed and hit his head. A few weeks later, he was declared brain-dead at the hospital. He was 26 years old.

His friends honored him with a memorial ride over the Williamsburg Bridge, and when a representative with LiveOnNY approached his mother about donating his organs, she accepted.

“She knew straight away. David would have done anything to help,” Irving said. “She was told she could never have children and she had David and she felt very much that he was a miracle and that by doing this the miracle would continue.”

When Irving informed Rodriguez that she had a potential donor for the face transplant surgery, the blood, genes and other features underwent a series of tests. When it was determined that it looked like a viable match, Rodriguez called Hardison in Mississippi with the news.

“When you look at the facial skeleton... they were only off by one or two millimeters,” he said.

Hardison was elated. “It’s what I’ve been waiting for,” he said. “Since 2001, I’ve been praying to God and this is the day.”

On Aug. 14, 2015, Hardison was prepped for surgery and wheeled into one operating room, while the donor was wheeled into an adjacent room. Before starting, the surgical team held a moment of silence to honor Rodebaugh.

0:45

Face Transplant Recovery: The First 90 Days

A look at how former firefighter and father of five Pat Hardison recovered from surgery over the first three months.

ABCNews.com

In a carefully coordinated surgery, Rodriguez slowly removed the donor’s face and scalp, including the outer skin, tissue, nerves and muscle, as the surgical team next door worked to remove the skin on Hardison’s face. With each step, Rodriguez updated the surgical team working on Hardison so that the two teams would remain in sync, and then they placed the donor face on Hardison. Among the trickiest parts of the surgery, Rodriguez said, was connecting the blood vessels.

“We got one chance to align to basically land this on the moon perfectly,” Rodriguez said.

In total, the surgery took 26 hours to finish. Rodebaugh’s heart, liver and kidneys were also donated, along with his corneas, bone and skin tissue.

Although the face transplant surgery was considered a success, Hardison faced a long road to recovery. There was also a risk that Hardison’s body would reject the transplant. Of the roughly 30 patients who have received partial or full face transplants, Rodriguez said some three to five patients have died after rejection.

Carefully, Hardison touched his hands to his face, exploring his new and unfamiliar features, as Rodriguez pointed them out to him.

“Look at your big blue eyes… see how nice your eyelashes are?” Rodriguez told Hardison. “You’re going to be able to drive, pick your kids up at school. ... that was a very courageous moment to see yourself for the first time… I’m very proud of you.”

His forehead and cheekbones began adding shape to his face, but he had to start the process of re-learning how to speak and swallow, two functions severely affected by the surgery.

“This operation was so extensive we did harm his swallowing mechanism,” Rodriguez said. “The patients during that stage, although we've prepared them when they're going through it, they wonder, ‘is this the way I'm going to be for the rest of my life?’”

Hardison spent the next few weeks battling through sometimes frustrating therapy sessions, but his swallowing slowly improved, the swelling went down and the feeling in his face began to return. He even practiced a few smiles.

Seeing him smile, Rodriguez said, is "amazing for me personally because all these gambles that we take, there are predictable risks that we take, to finally see that activated... watching all these milestones be met, I start feeling better and better."

This was a big step, Rodriguez said, because during the transplant surgery, he had placed the donor skin, nerves and muscle over Hardison’s face muscles with the hope that over time the donor’s tissue would connect to Hardison’s face.

“If the muscles are perfectly aligned with Pat's face, his muscles will power the new face and that's exactly what happened,” Rodriguez said.

Up until this point, seven weeks after his surgery, Hardison had only been communicating with his kids back in Mississippi by text message, never sending photos.

“I started becoming impatient,” said his daughter Alison, who is now 21. “I wanted to know what color hair he had, what skin tone he had, if he had tattoos. I mean just a million things went through my mind. I want to know about his lips, his eyes, if he had freckles, if he had moles.”

Unlike Hardison’s three oldest children, Braden and Cullen, the two boys who were born after the accident, never knew him any other way than how he appeared after the fire. Before they all made the trip to New York to see him for the first time, Hardison texted them a photo to lessen the shock of his new face.

“It was weird,” Braden said, talking about seeing the photo of his dad’s face for the first time. “All that time I didn’t know what he looked like and when I actually see the picture and see what he looks like now, it’s like ‘whoa.’”

When Hardison was finally reunited with his kids eight weeks after the procedure, there were hugs and tears all around.

It’s now been three months since the surgery, which Rodriguez estimates cost about $1 million and was paid in full by NYU Langone. The skin color is a close match to his own and his hair and beard are growing in, so Hardison is getting used to shaving again after 14 years. He can touch and feel his new ears, something he thought he would never be able to do again after the fire.

“I was asleep one night after I had just got out of surgery,” Hardison said. “I was laying there, and I think this ear was itching and I went to pull on it thinking, I was going to take it off, and I pulled, and I was like, ‘oh, that doesn't come off.’”

Another major milestone for him, he said, was going out in public after the surgery.

“I went to Macy's to get clothes and I was just another guy, nobody is pointing or staring. I wasn't scaring any kids,” he said. “It’s just-- it’s very emotional, to have that.”

So far, Hardison has exceeded all recovery expectations, but Rodriguez said he’s not out of the woods yet.

“In most patients that I've received a face transplant they have an acute rejection episode commonly within 30 to 90 days,” he said. “In Pat's case we've not seen an acute rejection episode. So I'm a little concerned of what that will look like. We hope that we won't experience it.”

Hardison remains in New York to work on his recovery and misses his children terribly, but said he FaceTimes with them several times a week. He still suffers from constant pain and is on pain medication, but has no regrets about choosing to go through with the face transplant surgery.

“I never one time thought about failing,” he said. “I thought about the risk of dying because that never scares me because I lived. There are things in life that are way worse than death.”

While he is still getting used to his new face, Hardison said he has started to see some of his old self again, but hasn’t forgotten about the donor who made it all possible.

“That donor and his family gave me this gift, and I can never thank them enough for giving me something as great as this, something I thought I would never have,” he said.