A patient who received a face transplant at Rochester's Mayo Clinic says he has a second chance at life.

Puff was near death from the gunshot wound. He was taken from a hospital near his home in Harbor Beach, Michigan, to a trauma center, where his parents were asked to consider organ and tissue donation because there was a chance he wouldn't survive. But Pfah endured and was airlifted to Henry Ford Hospital in Detroit, where he underwent numerous reconstructive surgeries.

Most of his nose was gone, leaving a gaping but blocked nostril in the middle of his face. There was a gap in the front of his skull and a titanium plate in place of the roof of his mouth, where his lips and most of his teeth were missing. Puff was having trouble eating, crying, smelling and breathing through his nose. The former high school football star, who was studying nursing at Saginaw Valley State University, was publicly humiliated.

“People were always pointing fingers at me,” he recalled. “I was at home most of the time.”

Mayo approved Pfaff's transplant because it appeared that the nerves in the back of her face were intact and would be able to transmit signals from her brain to the transplanted tissue.

“If the nerve is not functioning properly or cannot connect to the donor nerve, there is no point in doing the surgery,” said Mr Maldini, surgical director of Mayo's Reconstructive Transplant Program.

Psychological tests revealed that Ms. Pfaff would be able to cope with the consequences if the transplant failed, and would be able to adapt to a new external identity if the transplant was successful.