Facial transplantation, a groundbreaking field in reconstructive surgery, has emerged from advancements in tissue transplantation, microsurgical techniques, and immunosuppressive therapies. The concept of facial allotransplantation has roots in early 20th-century attempts at reconstructing complex facial injuries through Sir Harold Gillies, father of modern plastic surgery, principle of “replacing like with like”. 2025 marks the 20th anniversary of the first successful facial transplant. This was performed by Dr. Jean-Michel Dubernard and his team in France on patient Isabelle Dinoire – involving transplanting the nose, chin, and mouth from a donor. This has expanded from partial to full face, with Spain performing the world's first full face transplant in 2010. As of 2020, 47 face transplants have been conducted worldwide, including two retransplants, across 11 countries and 21 medical facilities. The development of facial transplantation has been characterised by meticulous planning, innovative techniques, and multidisciplinary collaboration. Surgeons now utilise 3D imaging, virtual surgery, and extensive rehearsals to refine their approaches. This surgical innovation represents a convergence of technical skill, ethical considerations, and dramatically improves quality of life for individuals with facial disfigurements. References Khalifian, S., et al. (2014) Facial transplantation: the first 9 years. The Lancet, Volume 384, Issue 9960, 13–19 December 2014, Pages 2153-2163 Pomehac, B., et al. (2011), Evolution of indications for facial transplantation. Journal of Plastic, Reconstructive & Aesthetic Surgery, 64(11):1410-6. doi: 10.1016/j.bjps.2011.06.024