Patients of surgeon Harold Gillies during WWI and WWII
Okay, these photographs pissed me off a bit, because they don’t show off how much of a genius Dr. Harold Gillies, the father of modern plastic surgery, was. Rhinoplasty, skin grafts, and facial reconstructions have been practised for centuries. However, it was this New Zealander surgeon who standardized these techniques and established the discipline of “plastic surgery.”
The introduction of more destructive weapons of WWI and WWII resulted in devastating injuries. In addition, in trench warfare, the head was more exposed than the rest of the body, and soldiers’ faces were often shattered or burnt beyond recognition. Despite the best efforts of surgeons, many soldiers were left hideously disfigured. Traditionally, the edges of facial wounds were simply stitched together, but when scar tissue contracted faces were left twisted and disfigured, so a new type of surgery was needed.
Gillies rebuilt faces using tissue from elsewhere in the body. Antibiotics had not yet been invented, meaning it was very hard to graft tissue from one part of the body to another because infection often developed, so Gillies invented the “tubed pedicle,” where he used a flap of skin from the chest or forehead and “swung” it into place over the face. The flap remained attached but was stitched into a tube. This kept the original blood supply intact and dramatically reduced the infection rate. After many bone reconstruction, skin grafting, and healing, which could take months to years, the tentacle-like tubing would be removed, and (volia!) a new face!
He was also the first to do sex reassignment surgery from female to male in 1946, then male to female using a flap technique in 1951, which became the standard for 40 years.