[ cheers and applause ] >> thank y. this is a special edition of "nightline." >> he is the former firefighter, severely burned in the line of duty. we're there with the pioneering surgical team ready to restore one man's face. a family's tragic loss and jen ross is the ray of hope this family's been fighting for. but the odds of survival, 50/50. his first look in the mirror and the tearful family reunion 15 14 years in the making. a hero's homecoming and pat's second chance to smile. >> this special edition of

cc1 test message test text1 underline test text you see in new york. my daughters would love it because they could shop forever. >> reporter: a loving father of five from mississippi who for 14 years now has hidden behind a hat and sunglasses. >> i'm going to have you take off your hat. >> reporter: that rest on prosthetic ears. >> take off your ear forth me for a second. let's see how these are doing. >> reporter: pat's come to nyu medical center to undergo the most extension ve face transplant ever attempted. a medical team led by eduardo

this unprecedented surgery for three years. >> this is a graphic image but it gives you an understanding of everything that's going to be removed. >> reporter: he warns pat the painstaking procedure to remove his scar tissued face and replace it with a new one could kill him. his chance of surviving just 50/50. >> the reality is we can make you much worse than you are now. and if this were not to work, we've actually made you worse than you were before. so you completely understand this, right? >> oh, yeah. >> reporter: it's a risk pat is more than willing to take. because for more than a decade pat's lived with the scars, both physical and mental, from the fire that turn burned off his face. >> a day just like every other fire. >> reporter: 2001, pat was a a house fire. he rushed headlong into the flames to rescue a woman believed to be inside.

home. me and pat were in the bedroom. everything kind of fell apart. >> i can't remember. i just remember the ceiling collapsed. coming down. >> reporter: pat's face was burned so badly the other firefighters didn't know it was him until they loaded him into the many plans. >> they pulled me down and he said, take care of christie and the kids. that's when i knew who i had. >> we closed the door on that ambulance and i figured it was the last time i'd ever see him alive. >> when i came back home i was a totally different person. >> reporter: pat spent 63 days in the hospital recovering from burns that robbed him of his scalp, ear and nose. his eyelid and lips also gone. when he got home his young children were terrified. >> the first time i realized what he had gone through was the first time i saw him. >> reporter: alison, pat's oldest daughter, was just 6 at

>> and i remember going up to the house and my mom and stepdad literally had to drag me in the house because i was scared. >> reporter: over time his devastated family adjusted. >> to us he became normal. he looked normal. we didn't think anything of it. >> reporter: ever the family man, he went on to have two more children. but inside, he was struggling. the guy once known as life of the party became withdrawn, depressed, and began abusing his pain medication. his friends felt helpless. >> it was hard for me to tell him. it's even harder for him to hear and accept it as the truth. >> reporter: he endured months of surgeries. doctors were able to apox mate a mouth, nose, and lips, facing those ears. >> look to the left. look to the right. >> reporter: but there was nothing they could did about his missing eyelids. without them pat would go blind. >> he went through 50, 60, 70 surgeries over a period of

i can't imagine what it does to you mentally. >> reporter: he was eager to do whatever it took to get his life back. hopes now pinned on a trail blazing surgeon. >> there are a lot of pieces that have to come together. >> reporter: in the emerging field of face transplants. >> did he need this surgery in the traditional sense? >> no. he could have stayed this way as long as he would have lived. however, pat was not living, by our standards. >> i'm that ready. >> for patients like that it's important for us to slow the they completely understand what they're getting into. >> these are great photographs. >> reporter: dr. rodriguez need the to manage pat and his family's expectations. >> what if we do the surgery and everything is reasonably successful, but your expectations are not met? today. i'm not saying it would be like i was. 2001. i'm saying, get me back

>> reporter: nyu langhorn medical center would cover the million-dollar procedure in the name of research. >> i break down about it. i knew it was something he would want to make him feel what woo would call normal again. >> reporter: but they needed the perfect donor. the wait was excruciating. >> day by day, get up every day? next day the same way. >> he told me he didn't know if he wanted to keep living. we prayed about it. and here we are getting the surgery. yeah, it was tough. >> reporter: only possible through a twist of fate that would forever link pat to a man he would never meet. >> dave was without a doubt like the best guy you never met. >> reporter: his name was dave rodebaugh, 26-year-old bike mechanic who lived in brooklyn, new york. dave loved to ride.

race last year. dave was fatally injured biking home from work. his tight-knit group of friends memorializing him with a ghost bike at the scene of his accident. dave's mom there for the tribute. dave matched every criteria pat and his doctors had been waiting for. age, hair, skin color, blood type, even skeletal measurements. when dave what's mom was asked if she'd donate his organs she didn't hesitate. >> she knew straight away david would have done anything to help. she was told she could never have children and she had david and she felt very much that he was the miracle and that by doing this the miracle would continue. >> reporter: dave was the perfect donor and his kidneys, liver and heart would save four other lives. >> the man that got his heart? i'd like to meet him and be like, i'd like you to know that you have a lion's heart. >> feel good? >> reporter: a quick hug from

into the o.r. dr. rodriguez's plan? remove what's left of pat's scarred face and scalp and replace them with donor tissue, muscles, nerves. the donor's body in the room next door where another surgical team takes a moment to reflect before surgery. >> may we now take a moment to honor the life of david rode rodebaugh. >> reporter: some of the footage you're about to see is graphic. the doctor works on the donor, every step finely choreographed with the team next door. >> watches are synchronized, the teams ready to go. >> reporter: the donor's face is slowly and delicately removed, perfectly timed and in sequence. they now begin removing pat's face. >> there's constant communication. they do not compromise the scalp until i can give confirmation the scalp is viable. they do not take the eyelids until they know i've reached the point of no return because we have to keep pat safe.

all times to know that we're on operation. >> reporter: eight hours later pat's face, which was mostly scar tissue, has been removed. >> when you take someone's entire face off, you're essentially looking at raw tissue. the muscles, the facial expression, the eyeballs are essentially exposed. >> reporter: pat is just a few feet away from his new face. the transplant can finally begin. >> there's a lot of concern in my mind, are we able to deliver this? we've got one chance to basically land this on the moon perfectly. >> reporter: when "nightline"

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cc1 test message test text1 underline how wear doing? >> reporter: halfway through the most ambitious face transplant surgery ever attempted doctors have removed the donor's face. a warning, some of the footage is graphic. former firefighter pat haddison is lying on the operating table next door, his now-exposed face

>> about when we remove the face and start going into the other room it's like starting a whole new operation. >> everybody ready? >> yeah. >> yep. >> reporter: lead surgeon dr. eduardo rodriguez positions the face. he now must quickly get blood circulating to it before the tissue starts to die. it's been without blood flow for almost three hours. >> until the face becomes pink my heart's racing. >> reporter: it's an intricate process stitching together the blood vessels. then within seconds -- pat's heart is pumping blood into his new face. >> the entire face, the scalp, the ears, everything, is pink. so at this point i'm feeling pretty good. but i know that we still have a lot more work ahead of us. >> reporter: the surgical teamworks straight through the night. >> we stabilize the remaining portions of the skeleton, we stabilize the inside lining of the mouth, we secure the eyelids are now we begin to inset the back of the scalp. >> reporter: anchoring bones,

the outer skin. the final sutures in place 26 hours after the surgery began. >> congratulations, everyone. excellent job today. >> when the surgery was over, what went through your mind? >> now you start thinking about what's going to happen? >> ironically, now you've entered the danger zone. >> correct. >> reporter: infection is the main concern. pat's immune system is compromised by the anti-rejection medications he'll be on for the rest of his-. nine days after surgery, pat is finally out of bed but has yet to see his new face. dr. rodriguez worries his new appearance could frighten him. >> are you nervous? no, not at all? do you have any idea what to expect? what it's going to look like? so here we go. here. give me your hand. go ahead and just turn that

let me see a gauze. >> reporter: he takes in his new reflection for the very first time. >> can you see your hair growing? can you see your beard? >> reporter: his hands exploring strange yet familiar features he thought he'd never have again. >> what do you think about the ear, this is great, right? how great is that? >> reporter: pat's recovery is remarkable. after nearly three months his new face taking shape over his own bone structure, his brow and cheekbones. sitting with him face-to-face 87 days after surgery, his scars hidden just under his collar, a 41-year-old man with a 26-year-old face. how are you feeling? >> i feel good. >> how much feeling do you have now in your face in your head? >> there's some -- here now has still got a ways to go. the swelling and the feeling. but everything else, it's coming along. >> reporter: we were finally

was willing to risk everything. >> i never thought like that, the risk of dying, that never scared me. because there are things in life that are way worse than death. >> there are things in life way worse than death? >> yeah. i had lived like that for 14 years. >> reporter: even though the speed of his recovery surprises doctors, the frustrating first few weeks post-surgery tests his limits. >> you had to relearn to swallow, relearn to chew, relearn to talk. >> i told the doctor rodriguez in the beginning, i said, you do your part, i'll do mine. >> because of this operation was so extensive, we did harm his swallowing mechanism. >> wait a minute, don't go now, don't go now. we've had this discussion for a year now.

it's so much better. >> reporter: pat spends hours every day training. >> deep breaths. you know what to do. >> reporter: fighting for every hint of facial expression. >> those muscles from the donor, they do not have any functional input the nerves are not connected. but the muscles are perfectly aligned with pat's face. his muscles willpower the new face. >> and smile. >> reporter: doctors say he'll get better at smiling, winking, talking. pat's already overwhelmed by the transformation. >> it's very emotional. >> what is that emotion? is that just -- >> i guess what they call happy tears. >> happy tears? >> i've been upset so much over the last 14 years. because i've had to face it every day. then now it's like -- people see

just a face in the crowd. >> that's all gram. another face in the crowd. >> what's been the hardest part of all of this? >> being away from my kids. >> being away from your kids? >> love you. >> love you. >> love you, miss you. >> reporter: his kids back in mississippi have yet to see a picture of their dad. shielding them until he's ready. >> pack mustard from new york. >> reporter: eight weeks after surgery -- >> excited about being dad? >> yes. >> scared, anxious? >> yes. >> excited? >> yes. >> reporter: they're getting ready to visit him. >> we're currently descending into new york. >> reporter: pat's nervous about how they'll react when they see his new face for the first time. >> i'm going to knock on the door. >> reporter: when "nightline" returns. i sure had a lot on my mind when i got out of the hospital after a dvt blood clot. what about my family?

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pat haddison's kids haven't seen their dad in two months. after receiving the most

he's kept his new appearance id hidden from them as he's healed. >> seeing my kids. nothing better than that. >> reporter: finally it's time to meet face-to-face. >> hey, dad. >> see? look. >> reporter: after an emotional embrace, they can't help but stare at their dad's new features. the whole ren ason he risked his life now coming into focus. >> i'm looking forward to getting my vision fixed hopefully and loading those kids up and taking them on a vacation to disney world or somewhere, just me, my kids, and the stuff that we missed out on. >> you missed out on a lot of their childhood.

i hate that. we're fixing to catch up now, though. >> reporter: six weeks later, reunited again as he returns home to mississippi. >> one, two, three. let me take a couple. >> reporter: a parade for a hometown hero. but he reserves that honor for the man who made it possible, his donor. >> he's the hero. he's the one. because he -- >> you're getting emotional. >> it's emotional when you think about it. that donor and his family gave me this gift. and i can never thank them enough for giving me something as great as this. something i thought i would never have.

langgold medical center and to pat and his entire family, all the best. thanks for watching abc news. tune into "good morning america" by tomorrow. as always we're online 24/7 on our "nightline" facebook page and abcnews.com. good night and have a very merry christmas. >> carbon monoxide poisoning on christmas. two people dead tonight as investigators work to find out