TROY AWAKENS
Troy comes out of his coma without signs of functional or cognitive debility, and unwraps his face. We get some great wet sucking sounds as he pads barefoot through a deserted hospital ward to discover Archer's face-skin floating in a dish. 
Troy is initially incoherent and starts screaming when he sees Archer's face, but he's a resilient psychotic terrorist and recovers his wits pretty quickly. Within hours (or less) he's sucking up a cigarette and on the phone to his henchmen.
Troy also talks on the phone pretty well. We see a bit later in a reflection of his faceless face that he's still got a lot of lip and cheek left, which explains why he is so coherent when speaking. It also explains how he can get that smoke out of his cigarette. Yes, smoking without a face, nice touch! It reminds me of the old films like Double Indemnity where Fred Mc Murray has been mortally wounded, is oozing blood everywhere, and wants a cigarette from Edward G. Robinson, which he smokes as he slips into unconsciousness(1).
My colleague Bill reports that the whole smoking without skin on your face thing had been done already. Hellraiser III apparently has a woman, with no skin at all, calmly smoking a cigarette.
We don't see Dr. Walsh and his team perform Troy's surgery as he takes on the face and body of Archer, but one again, the procedure is a success. surgery is performed and Troy is recovered before people come in to work the next morning.
FUN FACTS ABOUT TRANSPLANTATION
An allograft is a tissue graft between genetically dissimilar members of the same species(2). An autograft is a transfer of one's own tissues from one site to another(3). Transplantation is the transfer of living tissues or cells from a donor to a recipient(4).
So when Archer gets Troy's face the first time, it's transplantation/allograft. The question is, is it autograft when he gets his face back at the end of the film? Is there a name for a procedure where one has living tissue removed, and then re-attached to the same place after hanging out on someone else for awhile?
Allografts may be rejected by the recipient's immune system. this is a major danger for most types of transplants.
Image from Dailymail
As a plot point in the film, Troy's AB blood gives him away to Archer's doctor wife, which Archer's O- blood confirms that he is who he claims to be. I assume that both men are Rh negative(5), just for the sake of argument. If we only look at blood typing, people with type AB blood can receive type O, but people with type O blood cannot receive type AB (long story). So Archer's face might go onto Troy's body (assuming tissue compatibility for a moment) without major trouble, but Archer will probably reject Troy's face tissue that minute his blood vessels get his blood into Troy's tissues. CLOT CITY!
Next time: The final episode of Face/Off - Tissue rejection!
1. Chandler, Raymond, Billy Wilder, et al. Double Indemnity. Universal legacy series. Universal City, CA: Universal Studios Home entertainment, 2006. One of the bes love stories about two men in the insurance business.
2, 3, 4. Berkow, Robert. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 1992 p. 347
5. In the most basic of nutshells, Rh factor is a blood group discovered on the surface of erythrocytes (red blood cells, to you and me) of rhesus monkeys. Some people have this group (RH+) and some do not (Rh-). If you inject an Rh- person with Rh+ factor, their body will become sensitized to it. If injected with it again later on, perhaps via a transfusion, the Rh- person's body will have a transfusion reaction, which is an allergic reaction (cytotoxic hypersensitivity reaction for you trivia buffs). Red blood cell destruction and huge amounts of clotting are the result. Gues what "Rh" stands for...Yup! Rhesus!
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