Clinicians have duties to express regard for the breadth and depth of their influence on patients’ pre- and postsurgical self-understandings.

Success depends on strong support, rehabilitation, adherence, and social integration.

Despite drawbacks of immunosuppression and surgery, vascularized composite allotransplants can enhance lives of patients who meet candidacy criteria and are well supported.

Facial transplantation must establish approaches to assessing QoL in candidates and recipients that use meaningful outcomes.

Current QoL conversations in HTx could be enhanced by a phenomenological account of temporality, embodiment, and intersubjectivity.

Drs Katrina Bramstedt and Ana Iltis discuss the development of QoL assessment tools to help patient-subjects considering reconstructive transplantation.

Counseling a patient about reconstructive surgery for a traumatic and disfiguring injury requires special consideration.

Improving candidate evaluation and informed consent is key to motivating authenticity, not just voluntariness.

Clinician-researchers deeply invested in data gathering are still obliged to respect a patient-subject’s right to stop being in research.

Drawing on the film Wonder, this article examines how a narrative of community acceptance offers sustaining relationships for people with unusual facial appearance.