Not for the Faint Hearted (Yet Inspiring): WWI Case Studies of Facial Reconstruction

A student named Jason Bate, associated with Falmouth University, has produced a remarkable document I happened to stumble across. To tell the story of how surgeons during the First World War developed techniques to restore the faces of severely injured soldiers, he did a deep dive in the medical literature of the period to find photos of the step-by-step process surgeons took to help these poor souls. As you will see below, some of the restoration work seems almost miraculous. His entire article is available HERE. As a postscript for Bate's photos, I've added the story of one notable survivor of a facial injury and surgical restoration.

Lieutenant-General Sir John Bagot Glubb, KCB, CMG, DSO, OBE, MC (1897–1986) was a British Army officer seconded for many years to the Arab Legion of the Trans-Jordan. He wrote many books after his retirement, primarily on the history of the Middle East and on military history. His best-known work is The Fate of Empires. Glubb served in the First World War with the Royal Engineers, suffered a severe facial wound, and underwent a long reconstruction.  He eventually returned to service on the Western Front before the Armistice.  He later wrote of these experiences in Into battle: A Soldier's Diary of the Great War.

Before Combat and Much Later

 

I heard for a second a distant shell whine, then felt a tremendous explosion almost on top of me […] the floodgates in my neck seemed to burst and the blood poured out in torrents. […] I could feel something long lying loosely in my left cheek, as though I had a chicken  bone in my mouth. It was in reality, half my jaw, which had broken off, teeth and all, and was floating about in my mouth.

Like many soldiers facing similar circumstances, Glubb was transported back to England to await surgery and treatment for his injuries. Upon return home, however, disfigured veterans like Glubb faced a populace at that point incapable of accepting these “broken gargoyles” into a society wishing to overlook the atrocities of war. 

I lay for three months in my bed in Wandsworth during which my wound remained septic, and received no medical attention. …No doctor ever looked at our wounds or removed the bandages. Presumably there were not enough doctors. My mother used to visit me at Wandsworth. Through her I sent applications to all and sundry, for a transfer to another hospital. At last, in November 1917, three months after I had been hit, I was transferred to a new hospital for face injuries at Frognal, Sidcup, Kent. Here things were very different. My broken and septic teeth were extracted and my wound cleaned.

At Sidcup, disfigured soldiers waited to receive surgeries in the hope of restoring the original function and appearance of their faces. As lead surgeon, Dr. Gillies pioneered numerous surgical techniques in facial reconstruction, revolutionizing the work of reconstructive surgery. Working in what he deemed a “strange, new art”, Gillies required the precision of a skilled surgeon with the attention to aesthetic detail of an artist. He and his team developed various new techniques in 1917, like the tube pedicle, which allowed for the grafting of skin from one part of the body to another by keeping blood circulating at the reattached area.

Glubb was later shown an album of “photographs of handsome young men and asked to choose the chin I would like to have!” When discovering how long it would take to build this new chin, he decided to “retain his old face, or whatever was left of it.”  

He returned to the Western Front in time to experience the Armistice. Glubb's restored version of his "old face," shown above, served him well for the next six decades.

"World of Hurt", European Journal for Nursing History and Ethics; The Limits of Medical Discourse: Photography, Facial Disfiguration, and Reconstructive Surgery in England, 1916-1925, Jason Bate, 2014 Falmouth University Thesis