Fascinating and well researched.I did not know anything about plastic surgery and knew very little about World War I. This book brought the personal stories to life, from the soldiers, doctors and nurses to the artists and sculptors who helped reconstruct faces and lives.
There’s even a cameo by Marie curie. Well worth the read ( )

A brilliant, very well written exploration of Sir Harold Gillies life during the First World War as a military surgeon, and in particular as a military plastic surgeon. This is a story of a speciality in its childhood, and the foreword thinking pioneers who made things happen, developed techniques and established a centre for excellence, just outside London, in the Kent countryside. Also a tale of how, with team spirit, virtually any obstacle can be overcome. A triumph. ( )

THE FACEMAKER is an impressive, intense, and fact-packed book, not only about the development of plastic surgery, but also an insight into World War One and its devastating effects. I admit my understanding of the war was negligible prior to reading this, but now I have learned enough to have my interest piqued and I want to learn more. I have just requested a review copy of MEN OF 18 IN 1918 by Frederick James Hodges, a book that I would have certainly passed over if I had not read THE FACEMAKER.

Dr Harold Gillies is the titular surgeon who is constantly creating new ways to help disfigured soldiers (warning! Link leads to extremely graphic photos that may be disturbing) live normal lives. It is noted that those who had lost limbs were celebrated as heroes fighting for their country, while those who sustained facial injuries were shunned and considered freaks. The reasoning behind this is: faces and their ability to create expressions are what makes us “human”, and any deviation of what is considered “normal” creates discomfort. A face without a nose, or with a shattered jaw is difficult to look at, and so those poor soldiers were hidden away from the general public. The wards where those men were kept contained no mirrors, lest they catch a glimpse of themselves and lose the will to live.

Gillies is not the only doctor mentioned in this book; many other courageous surgeons contributed to the effort to repair these poor soldiers. The book is interspersed with descriptions of action on the Western Front, excerpts from diary entries from the soldiers that were lucky enough to have their journals survive (even if they didn’t), and accounts of how collaboration among the doctors furthered their knowledge and experience.

What fascinated me the most was hearing about the soldier’s activity on the battlefield, how he came to be injured, then his ordeal with Dr Gillies, enduring multiple operations while new techniques were tried time and time again. The book does contain a lot of graphic detail, so if you are squeamish, be aware.

I learned about artwork bringing attention to the soldier’s plight – one of the more poignant ones is the painting by John Singer Sargent entitled Gassed. The human cost of war is depicted in this 21-foot-long epic work. Other paintings and drawings are noted throughout the book, explaining how these methods helped the physicians rebuild faces. Sculpture was also used; multiple casts were made as the recreation and correction of each visage progressed.

The epilogue of THE FACEMAKER notes how plastic surgery evolved from a necessity to a luxury; rhinoplasty, facelifts, and the like were performed by Gillies long after the war was over. He continued to help others feel better about themselves until he died in 1960. He was a true visionary whose work ethic and kindness made the world a better place for many, many others. ( )

The story of the pioneering work done to rebuild the shattered faces of wounded soldiers could have been played for the gore aspects and shock value. Thankfully this is the opposite, taking a factual, sympathetic, and respectful tone that doesn’t shy away from the suffering, while always having a thread of hope.

While the discussions on surgical techniques and medical advances are fascinating, the heart of the narrative is the human ones from both the medical teams to the patients themselves.

A wonderfully balanced, fascinating, and engaging read. ( )

Excellent addition to WWI literature. The French called them gueules cassees - "broken faces." The industrialized weaponry of this war caused appalling injuries of all kinds, all the more dangerous for the filth of the trenches, wounds embedded with shredded uniforms, the absence of antibiotics or expertise in anesthesia or pain management, and the sheer numbers of afflicted men, delaying their care. While the loss of a limb might elicit sympathy, the terrible facial damage suffered by many caused visceral reactions of horror in the people who saw them and psychological traumas for the men who had lost the most visible manifestation of who they were: their faces. Eyes, noses, cheeks, lips, jaws were simply gone, torn away by bullets and shrapnel. Field hospital patch-up jobs left faces twisted, distorted, infected, scarred, unable to heal.

The Facemaker was Harold Gillies, a jovial, driven surgeon with a side line in amateur golf tournaments, who dedicated those years to caring for these men. In an age where "plastic surgery" wasn't even a widely-used phrase, he quickly understood just how complicated facial surgery was - delicate, highly vascular tissues in intricate layers of epithelium, dermis, and mucous membranes, with bony and cartilaginous structures underneath, that simply could not be stitched up like a lacerated leg. These men needed to be able to eat, to swallow, to breathe. There were few surgeons who even tried this type of work - several of them who did were dentists, who at least understood the architecture of the lower face. Gillies plunged in, experimenting, inventing, nursing along his patients, greeting new ones with a cheery: "Don't worry, sonny, you'll be all right and have as good as face as most of us before we're finished with you." He convinced military authorities to establish hospitals specifically for facial injuries, where patients could get the most rigorous specialized care - and where they were not outliers of deformity among less dramatically injured men. He hand-wrote labels to be sent to the front, instructing field staff to tag soldiers with facial injuries to be sent directly to him. He pioneered techniques of skin grafts, flaps and tubed pedicles that are standard procedures to this day. A fascinating aside is the work of a number of artists who worked alongside - notably, Henry Tonks, who created detailed drawings of these ravaged faces, to document their presentation, intermediate progress, and final results. There were women sculptors who created delicate masks of thin metal, replicating the men's original faces, to be worn over injuries that were impossible to repair - one of them was Kathleen Scott, widow of explorer Robert Falcon Scott.

Briskly written, impressively researched, Fitzharris's book also profiles a number of the patients themselves through their diaries, letters, memoirs, and family interviews. Their courage, tenacity and sometimes tragedy is deeply moving. Readers should note that the illustrations include a number of carefully chosen photographs of these men that are very difficult to look at, but in this context feel necessary to fully tell their stories.

Some years back, on a trip to London, I was able to visit the library of the Royal College of Surgeons. Serendipitously, they had a wondrous exhibit of Tonks's original drawings. This book is a terrific addition to the tragic and significant history of the Great War, its soldiers, its surgeons, and the history of medicine. ( )