Ten years have passed since the first transplant was conducted at the Cleveland Clinic. Face transplants, while far from common, no longer stir media interest. A formal registry has been established to record the clinical aspects of each procedure as it is completed. There are now close to 40, perhaps more, transplants that have been completed world-wide. I conducted a review of the first 36 procedures to find that 4 patients died, a survival rate of 89%. Opportunistic infections were common in a majority of patients and were for the most part well managed by antibiotics and antivirals. The procedure is gaining acceptance but many clinical, biological and ethical questions remain to be answered.