A 22-year-old who lost his lips, eyelids, and fingers in a burning car crash got a new face and hands in the first successful surgery of its kind

• Joseph DiMeo, 22, is the first-ever recipient of a successful double-hand and face transplant.
• DiMeo suffered 3rd-degree burns on 80% of his body after a stranger pulled him from a fiery car.
• DiMeo and his surgeon, NYU's Dr. Eduardo Rodriguez, spoke publicly for the first time Wednesday.

Joseph DiMeo was driving home from a night shift as a product tester in July 2018 when the 22-year-old fell asleep at the wheel. The car hit a curb and utility pole, flipped over, and erupted into flames.

A good Samaritan pulled over, leapt across a traffic median, and yanked DiMeo, from Clark, New Jersey, to safety. DiMeo had third-degree burns on about 80% of his body, an injury most people don't survive. He had no lips or eyelids, and his fingertips were useless.

But DiMeo not only survived; in August 2020, he became the first person in the world to successfully undergo a double hand and face transplant. Now, he's beginning to play with his dog Buster, lift light weights, play pool, and is looking forward to going back to work.

DiMeo and Dr. Eduardo Rodriguez, lead face transplant surgeon and chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone Health, spoke publicly for the first time Wednesday.

"I want to share my story to give people hope in the world," DiMeo said. "I'm grateful to have received a face and double hand transplant, which has given me a second chance at life."

Before the transplant, 'his life was completely derailed'

DiMeo was in a medically induced coma for more than two and half months after his accident, and remained in the burn unit of Saint Barnabas Medical Center in Livingston, New Jersey, for more than four months.

He underwent about 20 reconstructive surgeries, and had his fingertips amputated. And yet, the previously independent young man who loved to work and take selfies with the perfect angle still needed a contraption to feed himself, used his feet to take off his socks, and spent his days laying on his parents' couch watching TV.

His mom became his primary caretaker. "His life was completely derailed," Rodriguez said.

But there was nothing else doctors could do with conventional surgeries to give him a better quality of life, so he was referred to Rodriguez at NYU Langone, the only hospital in New York State and only one of a handful in the country with a dedicated program for face transplantation.

Rodriguez had completed three successful face transplants before, two at Langone. But no team in the world had performed a double hand and face transplant with success.

Two medical teams had tried: once in 2009 on a patient in Paris, who died about a month later from complications, and later in 2011 on a patient in Boston, whose transplanted hands needed to be removed days later.

But DiMeo was "the perfect patient" to become the first success story, Rodriguez said. His severely limited functioning meant he'd greatly benefit from the surgeries, plus he was young, healthy, and had no underlying conditions or evidence of substance use.

Most importantly, "he had that one special element, which was a high level of motivation, and he had a tremendous sense of hope," Rodriguez said. "He was the ideal type of patient for this challenge."

Finding a donor was like finding 'a needle in a haystack'

After being approved for the operation in October 2019, DiMeo needed a donor. Due to the complex procedures he'd already endured, there was only about a 6% chance of finding a perfect match, so the search was expanded nationwide.

Then, the coronavirus pandemic hit. "We became completely refocused on caring for patients who were completely damaged by this horrific health crisis," Rodriguez said. "Throughout this whole time, we never lost sight of Joe."

On August 10, 2020, a match was identified in Delaware - "a needle in a haystack," Rodriguez said. The same day, the unidentified donor was transferred to NYU.

Over the course of 23 hours on August 12 and 13, Rodriguez and his surgical team of 16 and operating room team of 80 completed the groundbreaking surgery. The six teams simultaneously operated in two rooms, one for the donor and another for the recipient.

In total, they transplanted both hands to the mid-forearm, including nerves, blood vessels, and 21 tendons. For the face, they transplanted the forehead, eyebrows, both ears, nose, eyelids, lips, and underlying skull, cheek, nasal, and chin bone segments.

"Often people think [a face transplant] is just like putting on a mask ... it's not that simple," Rodriguez told ABCin 2018 after performing his third such procedure on a man who'd survived a suicide attempt, according to the Daily Mail. 'The face needs to fit like a puzzle - and that's a tricky thing because we hit the point of no return."

To prepare, the team rehearsed for the operation once a month using a simulation lab. "We're going to take on the arduous task of ensuring complete success," Rodriguez told colleagues.

It was. When Rodriguez brought DiMeo's parents to see their son, it was "very emotional moment," as expected, Rodriguez said. "Finally, the weight is lifted off their shoulders that their son is back to normal once again."

Thanks to 3D printing technology, the team was also able to restore the donor's face and hands with replicas. "I'd just like to recognize the selflessness of my donor, and how none of this would be possible without his sacrifice," DiMeo said during the press conference.

DiMeo's recovery is ongoing

DiMeo spent 57 days in inpatient rehab before moving to outpatient care, putting in five hours a day of hand therapy, occupational therapy, face therapy, and physical therapy. "Joe is not one to back down, he's constantly asking more of his personnel," Rodriguez said.

DiMeo will take immunosuppressant medications for the rest of his life to prevent his body rejecting the transplants, and continues to undergo rehab.

But just four months post-transplant surgery, DiMeo was able to dress, feed himself, throw a ball to Buster, use light free weights and machines, and is practicing his golf swing. "He's the most highly motivated patient I've ever met," Rodriguez said.