Purpose Facial transplantation is a landmark development in reconstructive surgery, enabling restoration of form, function, and social identity in patients with severe facial disfigurement. This abstract reviews the history of facial transplantation, examining surgical evolution alongside ethical and psychosocial implications. Methodology A narrative historical review of the literature on facial transplantation was undertaken. Key milestones from the first face transplant in 2005 to the present, including reported postoperative outcomes, were reviewed. Major themes included advances in microsurgical technique and immunosuppression, ethical frameworks surrounding consent and donation, and psychosocial outcomes for recipients. Results Since 2005, approximately 50 facial transplants have been performed worldwide. Refinements in surgical technique, peri-operative care, and immunosuppressive regimens have improved allograft survival, with reported five-year survival exceeding 80%. Acute rejection remains common, and long-term morbidity related to chronic immunosuppression, including infection and malignancy, persists. Ethical debate has evolved with clinical experience, particularly regarding informed consent, donor family considerations, and patient selection for a life-enhancing rather than life-saving procedure. Psychosocial outcomes generally demonstrate improved quality of life and social reintegration, although long-term patient-reported outcome data remain limited. Conclusion Facial transplantation has progressed from experimental innovation to a viable but highly selective reconstructive option. Its history emphasises the need for multidisciplinary collaboration, ethical oversight, and sustained psychosocial support alongside surgical excellence. Ongoing challenges related to immunosuppression, outcome standardisation, and resource allocation will continue to influence the future role of facial transplantation.