Texas:
A man who lost his entire face after suffering horrific burns has become eligible for a full face transplant thanks to a reform of US health laws.
Dallas C Wiens is hoping to become the third American to undergo such a surgery. Despite his horrific burn injuries he's more hopeful than ever. That's because doctors have told him he is eligible to have a complex and costly face transplant. A change in federal laws means his treatment costs will be met by his family's health insurance.
The Department of Defense will pay for the cost of surgery. It's underwriting the transplant with the hope of eventually being able to help soldiers with severe facial injuries. Although doctors were able to transfer skin and muscle from Wiens' back and thighs onto his charred skull, he still doesn't have lips or a nose.
Although his eyes are covered by skin, hospital photographs show just how far he's come since the accident which burned away his face two years ago.
Wiens has already had more than twenty operations and completed dozens of physical and psychological tests at the Brigham and Women's Hospital in Boston.
The hospital is one of just two US centres able to perform the procedure.
Plastic surgeon Dr. Jeffrey Janis of Parkland Health and Hospital System has supervised his treatment so far.
Janis says "you can see he's (Wiens) got no eye on the left side, the eye on the right side doesn't work, he's got no identifiable facial features, his nose is gone, cheeks, lips, his teeth, those are all gone."
According to Janis "this is the point modern reconstructive surgery would have ended if this was three ago, five years ago. But now we're talking about face transplantation, so you can take a devastating burn injury like what you've seen and now you can make even better than this."
Janis is pleased with Wiens' progress so far.
But he says a few years ago this would have been the sum total of all they could do for him.
According to Janis "if this was five years ago that really would have been the end of the story. The fact that he is on a transplant list is really very novel, very cutting edge, this is something as I've said is not performed on a routine."
Wiens understands that even after the transplant he will have to undergo months of healing.
But it means that he will have feeling in his face for the first time.
He says "though it will not be instantaneous and there's a lot of therapy involved in regaining that mobility and that feeling, I will eventually gain feeling in my face again and at present I have none aside from the exterior on the parameter of my face".
Wiens has no memory of the November 2008 accident that took his face.
He was working as a decorating contractor with his brother and uncle when it happened.
Wiens was painting a church high above the ground on a boom lift when he hit a power line.
He was in a coma for three months and spent a total of six months at Parkland Memorial Hospital in Dallas.
A smooth layer of skin now covers where his eyes and nose once were and he has learned to get around with the help of a walking stick.
Despite having no lips, or teeth he speaks with a strong, clear voice.
Janis says "the fact that he's even available and alive and walked out of a hospital to be put on this list is a story in and of itself. When he first came in this was one of the most devastating injuries that anybody has ever seen, myself included."
For Wiens the greatest hope he has is to lead as normal a life as he can.
He says his three year old daughter _ who refers to his facial deformity as his "boo boo" _ and his faith have kept him motivated and given him a purpose, although he says he's a little nervous at the thought of the transplant, but he's very excited too.
He says "I see every day as a challenge, an opportunity for hope and joy. I'm happier now than I think I've ever been in my life."
About a dozen face transplants have been performed worldwide since the first one in France in 2006.