Feb 17, 5:55 PM EST

AP Exclusive: Twin tragedies give survivor a new faceThe first face transplant performed at Mayo Clinic is providing a young man from Wyoming a second chance at a normal life after he was disfigured by a gunshot in a suicide attempt a decade agoAP Exclusive: Twin tragedies give survivor a new faceThe first face transplant performed at Mayo Clinic is providing a young man from Wyoming a second chance at a normal life after he was disfigured by a gunshot in a suicide attempt a decade ago


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AP Photo/Charlie Neibergall
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ROCHESTER, Minn. (AP) -- He'd been waiting for this day, and when his doctor handed him the mirror, Andy Sandness stared at his image and absorbed the enormity of the moment: He had a new face, one that had belonged to another man.

His father and his brother, joined by several doctors and nurses at Mayo Clinic, watched as he studied his swollen features. He was just starting to heal from one of the rarest surgeries in the world - a face transplant, the first at the medical center. He had the nose, cheeks, mouth, lips, jaw, chin, even the teeth of his donor. Resting in his hospital bed, he still couldn't speak clearly, but he had something to say.

He scrawled four words in a spiral notebook:

"Far exceeded my expectations," he wrote, handing it to Dr. Samir Mardini, who read the message to the group.

"You don't know how happy that makes us feel," Mardini said, his voice husky with emotion as he looked at the patient-turned-friend he had first met nearly a decade earlier.

The exchange came near the end of an extraordinary medical journey that revolved around two young men. Both were rugged outdoorsmen and both just 21 when, overcome by demons, they decided to kill themselves: One, Sandness, survived but with a face almost destroyed by a gunshot; the other man died.

Their paths wouldn't converge for years, but when they did - in side-by-side operating rooms - one man's tragedy offered hope that the other would have a second chance at a normal life.

--

It was two days before Christmas in 2006 when Andy Sandness reached a breaking point.

He'd been sad and drinking too much at that time. That night after work while "super, super depressed," he grabbed a rifle from a closet. He stared at it for a while, then put a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.

Instantly, he knew he'd made a terrible mistake. When the police arrived, an officer who was a friend cradled him in his arms as Sandness begged, "Please, please don't let me die! I don't want to die!"

He was rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. When he woke, his mother was holding his hand. She'd always been a strong woman but that day, her face was a portrait of unfathomable pain. The bullet had obliterated his mouth, so he motioned for a pen and paper.

"I'm sorry," he wrote.

"I love you," she replied. "It's OK." But all Sandness could think about was how he'd hurt his family - and just wonder what was next.

The answer came quickly when he met Mardini, a plastic surgeon whose specialty is facial reconstruction. As a newcomer at Mayo, the doctor was on call Christmas Eve. Over the next few days, he reassured Sandness that he'd fix his face as best he could.

"I just need you to be strong and patient," he said.

It would take time and much surgery. And despite their skills, the doctors couldn't miraculously turn him back into that guy with the orthodontist-perfected smile.

Sandness couldn't bear to see himself, so he covered his hospital room mirror with a towel. He had no nose and no jaw. He'd shot out all but two teeth. His mouth was shattered, his lips almost nonexistent. He'd lost some vision in his left eye. He needed breathing and feeding tubes at first.

Mardini and his team removed dead tissue and shattered bones, then connected facial bones with titanium plates and screws. They reconstructed his upper jaw with bone and muscle from the hip; they transferred bone and skin from a leg to fashion the lower jaw. They used wires and sutures to bring together his eyelids, which had been spread apart by the powerful blast.

They made progress, even if it didn't always look that way.

After about eight surgeries over 4