Before botox and browlifts, even before McIndoe’s famous Guinea Pig Club, forces faces were rebuilt thanks to a little-known pioneering plastic surgeon
You get an odd compulsion as you step into the National Army Museum’s latest exhibition, Faces of Battle; at first you want to back away, but the images are so fascinatingly unlike anything before seen in public that you stop dead in your tracks, and stare.
The images that welcome you are graphic and initially upsetting. But you are invited to stare because this is a story that needs to be told; the story of the men whose shocking injuries and suffering paved the way for modern surgery.
The wounds caused by World War I were unprecedented – hot metal and shrapnel caused utter devastation to flesh. Trench warfare meant that facial injuries were more common as the head was often the only body part exposed to the enemy. With the threat of infection due to filthy conditions, the battlefield surgeon had no choice but to stitch wounds back together as soon as possible, whatever the damage.
This crude method caused scar tissue to contract, leaving soldier’s faces permanently impaired. Some injuries were so severe that soldiers could not swallow or even breathe.
Urgent help was required. By chance, a young, ambitious surgeon named Harold Gillies was working as a dentist’s assistant on the Western Front. Recognising that there was a growing need for extreme facial surgery, Gillies set up a dedicated ward at the Cambridge Hospital in Aldershot.
But nothing could prepare his team for the fallout after the Battle of the Somme; they expected 200 casualties but received 2,000, resulting in the opening of Queen’s Hospital, Sidcup in 1917. It was here that Gillies and his expert advisors – which included dentists, anaesthetists, nurses and even artists – used pioneering methods that not only restored damaged faces, but laid down the base rules for today’s plastic surgery methods.
The severity of the wounds meant new techniques were required. For instance, the modern method of intravenous anaesthesia was invented by necessity, as Gillies kept falling asleep at the operating table from inhaling ether exhaled by his patients.
Each patient’s needs were different, as showcased in the exhibition’s centrepiece, Project Facade. The work of artist Paddy Hartley, it uses authentic uniforms and bespoke facemasks to demonstrate how the grafts were carried out, proving just how resourceful and innovative the procedures had to be.
Skin grafts would often need to cover large areas, so they were performed using ‘pedicles’, where skin was cut from healthy tissue, leaving one end still attached. The ‘free’ end was swung into place over the damaged area. Keeping it attached meant blood could flow, and skin could heal over the damaged area. While working on one patient, Gillies noticed that the pedicle was curling under tension, so he stitched it into a tube. This became one of his biggest triumphs as the serious risk of infection was greatly reduced.
Sadly, not all of Gillies’ experiments were successful. Patient Henry Ralph Lumley died following an ambitious operation using a large flap of skin to repair his severely burned face. Although Gillies couldn’t save Lumley, the lesson of gradual grafts saved countless later lives.
But even when procedures were successful, psychological wounds could not be operated on. For Gillies’ patients, the path back to Civvy Street would be littered with obstacles. So the hospital doubled up as a rehabilitation facility. Courses such as cinema projection and coachbuilding were provided to help the men find work post-recovery.
Exhibition Co-curator, Samantha Doty remarks: "Gillies rebuilt not only faces, but self-esteem damaged by the war. This exhibition is about remembering, not Remembrance. Some died. But most lived."
