Eleven months after he underwent a face transplant surgery in New York, Cameron Underwood is smiling again.

The 26-year-old man from Yuba, Calif. lost the majority of his lower jaw, his nose, and all but one tooth after he suffered a self-inflicted gunshot wound to the face in June 2016.

After several unsuccessful attempts at conventional facial reconstruction, Underwood and his family reached out to renowned plastic surgeon Dr. Eduardo Rodriguez, a professor of reconstructive plastic surgery and the chair of plastic surgery department at NYU Langone Health.

Soon after, Dr. Rodriguez met with Underwood and determined he was a good candidate for a face transplant.

“When we first met Cameron, we were confident we could improve his appearance and, more importantly, his function and quality of life,” Dr. Rodriguez said in a press release on Thursday.

Underwood only had to wait six months after being placed on the organ donor list in July 2017 before a perfect match was found for him. William Fisher, a 23-year-old writer and aspiring filmmaker from New York, had registered as an organ donor before his death and was selected as a compatible donor for Underwood.

After receiving permission from Fisher’s family and securing the appropriate approvals, Dr. Rodriguez prepared to lead a surgical team from NYU Langone Health in the third face transplant of his career, the second of which is widely considered to be the most extensive face transplant on record, according to the health centre.

The plastic surgeon said he was optimistic about Underwood’s chances for success because of the relatively short period of time – only 18 months – from when he was injured to the surgery.

“Cameron has not lived with his injury for a decade or longer like most other face transplant recipients have,” he said. “As a result, he has not had to deal with many of the long-term psychosocial issues which often lead to issues like severe depression, substance abuse, and other potentially harmful behaviors.”

In January, a team of more than 100 medical professionals from NYU Langone Health transplanted and reconstructed Underwood’s upper and lower jaws, his mouth, and all 32 teeth and gums. His nose, lower eyelids, and cheeks were also replaced during the 25-hour surgery.

The surgical team used state-of-the-art technology, including 3D imaging and intraoperative CAT scans to ensure the facial bones were perfectly aligned and the plates and screws to graft the donor face onto Underwood were in the correct position.

Following the successful surgery, Underwood spent several weeks in hospital before he was discharged ahead of schedule in February. He returned home to California and has been travelling to New York for monthly follow-up appointments ever since.

On Thursday, Underwood stood on stage before an audience – which included his beaming family – to show off the results from his surgery nearly a year ago. He took the opportunity to thank Dr. Rodriguez and his medical team as well as his donor’s family.

“I want Sally [Fisher’s mother] and her family to know how much my family and I appreciate their gift and I will always honour Will’s legacy,” he told the press conference on New York.

Although she was saddened by her son’s death, Sally said she was thankful that his decision to become a donor could give Underwood a second chance.

“Being a part of this experience has been a source of strength for me during a very difficult time. I don’t think I would have survived Will’s death if not for Cameron,” she said in a statement. “Cameron has his whole life ahead of him – and I love the idea that Willie is helping him have a better life.”

Despite Underwood’s impressive results, Dr. Rodriguez said his patient still has a lot of work to do in his healing process, such as improving his chewing, swallowing, and speaking. He will also have to continue taking anti-rejection medications for the rest of his life so his body doesn’t reject his new face.

Even though his road to recovery isn’t over, Underwood said he’s remaining positive and looking forward to the future. He also took a moment to praise Dr. Rodriguez for his efforts.

“He did such a good job, I can use my old ID,” he joked to local news station WCBS after the press conference.