{"id":17551,"date":"2022-08-31T11:05:40","date_gmt":"2022-08-31T09:05:40","guid":{"rendered":"https:\/\/www.historyextra.com\/?p=214754"},"modified":"2022-08-31T11:21:10","modified_gmt":"2022-08-31T09:21:10","slug":"this-was-a-time-when-losing-a-limb-made-you-a-hero-but-losing-a-face-made-you-a-monster","status":"publish","type":"rss_feed","link":"https:\/\/c01.purpledshub.com\/bbchistory\/rss_feed\/this-was-a-time-when-losing-a-limb-made-you-a-hero-but-losing-a-face-made-you-a-monster\/","title":{"rendered":"\u201cThis was a time when losing a limb made you a hero, but losing a face made you a monster\u201d"},"content":{"rendered":"

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By Kev Lochun\n \t\t<\/p>

Published: Wednesday, 31 August 2022 at 12:00 am<\/p>

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Your book focuses on Harold Gillies, a surgeon in the First World War who made huge strides in facial reconstruction surgery. But how far back in history can we trace plastic surgery?<\/h3>\n
It pre-dates the First World War<\/a>, so I don\u2019t want anyone to think that Harold Gillies is the father of plastic surgery as a whole. The term \u201cplastic surgery\u201d was coined in 1798. At that time, plastic meant something that you could mould and shape \u2013 so in this instance, a patient\u2019s skin or soft tissue. And attempts at early reconstruction of the face or to alter the appearance tended to focus on really small areas of the face. Rhinoplasty [reconstructing the nose] is one of the oldest surgical procedures on record, dating back to around 600 BC. It wasn\u2019t until the American Civil War<\/a> that there were attempts to reconstruct the entire face, and even then it was quite limited.<\/p>\n

How has facial disfigurement been viewed through history?<\/h3>\n
Disfigurement has been strongly associated with shame, because of its association with disease. Syphilis, which ravaged much of the world for centuries, caused \u201csaddle nose\u201d, where the nose would cave in. People associated syphilis \u2013 and the disfigurement it caused \u2013 with a moral failing.<\/p>\n
The other thing was that sometimes someone would be purposely disfigured as a form of punishment: people\u2019s noses were injured purposefully for sexual transgressions such as prostitution or adultery. And this stigma really continues even to today. If you look at Hollywood movies a lot of villains are facially disfigured, like the Joker or the Phantom of the Opera, and that\u2019s a really lazy trope to say that the person is evil or has some kind of moral failing.<\/p>\n
You write that there was a huge need for facial reconstruction during the First World War. Why was this?<\/h3>\n
Trench warfare led to sky-high rates of facial injuries \u2013 many combatants were shot in the face simply because they had no idea what to expect. One surgeon wrote: \u201cThey seemed to think they could pop their heads up over a trench and move quickly enough to dodge the hail of machine-gun bullets.\u201d Men were maimed, they were gassed, they were kicked in the face by horses. During the war, around 280,000 men from France, Britain and Germany alone suffered facial trauma.<\/p>\n
This was a time when losing a limb made you a hero, but losing a face made you a monster to a society that was largely intolerant to facial differences. Whereas a prosthetic limb doesn\u2019t necessarily need to look like the arm or leg it\u2019s replacing, a face is an entirely different matter.<\/p>\n
Q&A | How long have people used prosthetic limbs?<\/a><\/strong><\/li>\n<\/ul>
Any surgeon willing to undertake the monumental task of reconstructing a soldier\u2019s face at this time not only had to consider the loss of function such as the inability to eat or to swallow, but they also had to consider the aesthetic, so that the face was deemed socially acceptable. As a result, plastic surgery flourished during the First World War, and was eventually ushered into the modern era by men like Harold Gillies.<\/p>\n
How did Gillies first become involved in facial reconstruction?<\/h3>\n
Gillies was an ENT (ear, nose and throat) surgeon, and he volunteered to go over with the British Red Cross when the war broke out. He was introduced to facial reconstruction on the western front by a really amazing character called Charles Valadier. He was a French-American dentist who retrofitted his Rolls Royce with a dental chair and drove it to the front under a hail of bullets; I mean, he was an absolute legend.<\/p>\n
So Gillies went back to Britain and petitioned to open his own specialty facial reconstruction unit at the Cambridge Military Hospital in Aldershot, and that\u2019s how it all began. Eventually he was so overwhelmed by the number of men needing his help that in 1917 he opened the Queen\u2019s Hospital, which later became Queen Mary\u2019s Hospital, in Sidcup \u2013 a hospital dedicated to facial reconstruction.<\/p>\n
Read more | 7 surprising facts about the history of medicine<\/a><\/strong><\/li>\n<\/ul>
What was unique about his approach to facial reconstruction?<\/h3>\n
Gillies wasn\u2019t the only surgeon operating on faces in this period. There were people in other countries that were doing this \u2013 like Jacques Joseph, a Jewish-German surgeon working for the Germans \u2013 but they tended to work alone. They didn\u2019t bring on, for instance, dental technicians, who were actually really key in facial reconstruction.\nGillies was the opposite and recognised their importance from the start.<\/p>\n
He brought a dental surgeon called William Kelsey Fry into the Queen\u2019s Hospital, and really worked in tandem with him. While they were reconstructing a patient\u2019s jaw, for instance, Kelsey Fry would be working on aligning the teeth and the jaw and getting all of the prosthetics in place, and Gillies was working on the missing chunks from the face, and the soft tissues that were damaged. So it was really a team effort.<\/p>\n
What other professions did Gillies collaborate with?<\/h3>\n
He also brought in artists, photographers, radiographers and mask makers, building a wonderful creative team who all worked towards rebuilding a soldier\u2019s face. One of the artists was Henry Tonks, who\u2019s quite famous in his own right, and he spent a lot of time at the Queen\u2019s Hospital drawing these men in the colours of the war, such as lurid greens and crimson reds [in doing so, Tonks provided a more vivid picture of their injuries than black-and-white photos]. The artists made diagrams of the surgeries, too, which proved hugely important.<\/p>\n
How did mask-making fit into plastic surgery?<\/h3>\n
The masks were non-surgical solutions that were created by artists like the sculptor Anna Coleman Ladd, who worked out of a studio in Paris. And they\u2019re exquisite \u2013 when you look at them, it looks almost like a human face. But you have to remember that they are still unmovable. If you were sitting in front of someone wearing one of these masks, it could be a bit unsettling because the masks were expressionless; they couldn\u2019t operate like a face. They were also very uncomfortable to wear, they were fragile, they didn\u2019t age with the patient. So long-term, they weren\u2019t really a solution.<\/p>\n
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