It’s been more than two years since Joe Dimeo could smile.
In July 2018, Dimeo, 20 at the time, fell asleep at the wheel of his car on Route 22 in New Jersey. He lost control, and the car hit the curb, flipping over before bursting into flames.
A passerby pulled him out of the car before it exploded, but Dimeo still suffered third-degree burns over nearly 80% of his body. The damage was so severe that, though Dimeo survived, he was left without eyelids, ears and much of his fingers. He also had severe scarring on his face and neck that limited his range of motion. The scars even partially covered his eyes.
His independence had been taken from him in an instant.
On Wednesday, doctors at NYU Langone Medical Center announced that, following 23 grueling hours of surgery, the now-22-year-old Dimeo was on the road to gaining his life back as the recipient of the world’s first successful face and hands transplant.
“He’s the most highly motivated patient I’ve ever met,” Dr. Eduardo Rodriguez, head of the team that completed the unprecedented surgery, told reporters at a Wednesday news briefing.
Though the surgery occurred in August of last year, Dimeo’s doctors waited to ensure the transplants were not rejected before calling the operation a success.
“There have been over a hundred hand transplants performed successfully, and close to 50 face transplants,” Rodriguez said. “So fundamentally there was no reason why they couldn’t occur together, successfully.”
There have only been two previous attempts to complete such a surgery — to transplant a patient’s face and both hands — worldwide. Both were unsuccessful.
“We needed to avoid infection, we needed to have this operation occur as fast as possible, we had to be very selective with the donor, and we had to implement every state of the art technology that would ensure complete success of Joe’s operation, and that’s exactly what we did.”
“Joe is healthy, he’s young, he’s strong, he loves to exercise, he eats healthy, and he had that one special element which is going to be required for this operation,” Rodriguez said, “A high level of motivation. And he had a tremendous sense of hope.”
The operation took 80 people across six surgical teams and two adjoining operating rooms.
In one, the hands and facial tissue of a dying donor were carefully removed and replaced with 3D printed prosthetics.
“We always begin the operation with a moment of silence to honor the donor family, to respect their great loss, to never forget the donations that have been made,” Rodriguez said. “In all these operations it’s important to recognize that someone must give up their life so that others can continue living.”
In the other operating room, Dimeo’s own hands and face were removed with precise cuts, to prepare him for the donor tissue.
The operation was one that could very well have ended Dimeo’s life if not done correctly, Rodriguez said.
At Dimeo’s arms, each radius and ulna bone was carefully cut, along with a host of tendons, muscles, veins and nerves, to prepare him for the new limbs. The right hand, Dimeo’s dominant hand, came first. Then the left.
“We have to replace 21 tendons, three major nerves, five major vessels, two major bones,” Rodriguez said of each hand. Each structure had to be labeled, he added, to ensure proper reassembly.
After Dimeo’s face was removed, small plates were put on his chin to help attach his new face, and the bridge of the donor’s nose was grafted in place of his own. Nerves and vasculature were spliced together, to bring blood and eventually feeling to the tissue.
After 23 hours of surgery, the final stitch was made. Forty-five days in intensive care came next, followed by nearly two months of inpatient rehab, Dimeo learned to open his new eyelids, to move his new hands, and to smile.
On Wednesday, Dimeo’s hands were every bit his own as he fished a written statement out of the breast pocket of a sport coat and held it up to read before newly opened eyes.
“I want to share my story to give people hope in the world,” he said.
“I’d like to recognize the selflessness of my donor, and how none of this would be possible without his sacrifice,” Dimeo said. “Thank you.”
Asked how he’s felt over the past few months of rehabilitation, Dimeo said he felt he’d been given a “second chance at life.”
“There’s no excuse to not be motivated, or not to do my therapy,” he said
“My hands aren’t there yet. I have to keep practicing,” he added.
“It’s kind of like when you’re a baby, they’re just moving their hands all the time until they get that ability to do stuff. I’ve got new hands now, just like them,” he said.
“There’s always light at the end of the tunnel,” Dimeo said. “You never give up.”