This comprehensive review examines the evolution of facial transplantation over the past 15 years, summarizing global clinical experience, surgical advancements, and long-term patient outcomes. The authors analyze trends in patient selection, operative technique, immunosuppression, and functional recovery, highlighting both the successes and ongoing challenges of facial vascularized composite allotransplantation. The article provides an authoritative overview of the field’s maturation and outlines key considerations shaping the future of facial transplantation.