Stunning images have revealed the remarkable recovery of a former high school football standout who underwent one of the worlds first facial transplant surgeries.
Derek Pfaff, 29, shot himself in the head with a 10-guage shotgun in March 2014, blowing most of his face off in a failed suicide attempt.
Although he survived the gunshot wound, Derek was left with gruesome facial injuries and he was unable to smile, eat solid food, blink or smell.
In the decade since, he underwent 58 plastic surgeries that kept him alive, but was still left with a number of issues stemming from the suicide attempt.
Despite only around 50 facial reconstructions ever being attempted before in history, Derek took the leap in February and approved the daring surgery at the Mayo Clinic in Rochester, Minnesota.
The surgery involved over 80 medical professionals across a 60-hour period, which reconstructed around 85 percent of Dereks face.
And even after the surgery was done, Derek had to wait over a month before seeing the results, and all phones and mirrors were removed from his room while his new face healed.
When he finally was presented with a mirror, he could not yet make a facial expression but was able to say a few words.
Looks good, he told his family. Feels good.
Derek Pfaff, 29, shot himself in the head with a 10-guage shotgun in March 2014, but miraculously survived. He has now become one of the few people to successfully undergo a face transplant
Derek was left with gruesome facial injuries and was unable to smile, eat solid food, blink or smell, undergoing almost 60 emergency surgeries before his facial reconstruction
When Pfaff attempted suicide a decade ago, he had the world at his feet.
He was graduating top of his class at Harbor Beach High School, and had spent the past year as a standout player on his varsity football team, even scoring the winning touchdown on his teams way to winning the state title.
But the pressures of being a perfectionist led to his attempted suicide, and after shooting himself Dereks parents said they found their son laying lifelessly in the snow.
His mom Lisa said it was a miracle Derek survived, and he spent years in hospital being kept alive by surgeries and urgent medical interventions.
Dereks first plastic surgeon Dr. Kenneth Moquin said when he first saw the college student, he was stunned that he was still alive.
He told the Detroit Free Press the bullet blew away his jawbone.
It blew away the top part of the inside of his mouth, in addition to the bottom side of his mouth, and part of his tongue. Some of the projectiles were lodged in the frontal lobe of his brain, he added.
Despite his injuries, Derek gave his family hope after he wiggled his foot on command while in the ICU, which his mom Lisa said, gave us hope.
We were like, OK. Were gonna do this... Its gonna be a long road... but it was OK, she said.
The facial reconstruction surgery involved over 80 medical professionals across a 60-hour period, which reconstructed around 85 percent of Dereks face
Dereks surgeons said they were stunned he survived the suicide attempt after he blew off his jawbone, tongue, most of his face and had projectiles lodged in the frontal lobe of his brain
After Derek approved his final surgery, medics still had to find a very specific donor, as the match had to fit Dereks face, age, gender, blood type, skin tone, and be on life support.
Mary Prince, a donation liaison with LifeSource, Minnesotas organ procurement organization, told the Star Tribune she was stunned when they found a match in North Dakota and approached the subjects mother.
The first words out of her mouth were, That would be so amazing if I could see my sons face walking around! Prince recalled.
She said the mother told her: I would be grateful and I would love to meet (Derek)!
After surviving the ordeal, Derek said he now has a new lease of life and focuses on mental health advocacy work for others struggling like he was
Following the exhaustive search for a donor, surgeons then had to calculate how much bone and tissue to remove from Dereks face, including lining up 18 nerve branches so he could blink and eat properly.
At the halfway point, Dr. Samir Mardini told the Star Tribune that Derek was nothing more than exposed eyes, tongue and blood vessels.
Doctors then rebuilt Dereks skull before draping his new face over his old one, before it was stitched together around his forehead and chin.
Mardini said Dereks surgery also involved a micro-surgery to reroute his tear ducts so they would roll down his face.
Although the Mayo Clinic performed Dereks surgery back in February, the clinic only released the results of his surgery this month.
Although the ordeal lasted 10 years and hundreds of thousands of dollars, Derek said he now has a new lease of life and focuses on mental health advocacy work for others struggling like he was.
If something is on your chest, talk to someone. Get it off, he said. Its normal life. This is who I am. I cant be more thankful.