‘Losing Face’: trauma and maxillofacial injury in the First World War

Fiona Reid writes on soldiers of World War One who suffered facial injuries

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The Western Front of the First World War was an industrial battlefield. The extensive fire-power of modern weaponry resulted in horrific head wounds and in men suffering serious injuries to the jaw and the soft tissues of the face (maxillofacial injury). In previous wars these men would have died but the medical advances of the early twentieth century ensured that more and more of these men were able to live, albeit with painful, enduring and unsightly wounds. There is no ready, colloquial term for these men in English but they were known as les gueules cassées (men with smashed faces) in France.

A delegation of les gueules cassées attended the official signing of the Treaty of Versailles and images of mutilated men feature in the post-war painting of Otto Dix and George Grosz. These men were emblematic of the horrors of war. Yet the presence of facially-wounded men was more difficult to tolerate in everyday settings. In Sidcup, Kent, blue benches were reserved for the exclusive use of such men, a strategy designed to protect passers-by from graphic and brutal reminders of the recent war.

During and after the war the pioneering work of Harold Gillies ensured the survival of many men and was the basis for later developments in reconstructive surgery. The concept of plastic surgery, which holds out the promise of literally re-shaping the self, had an extraordinary cultural impact both during the war and afterwards. Nevertheless the emotional trauma of these men without faces, and the reactions of their families and communities, has remained a neglected subject.

These men were not directly traumatized by their combat experience but by the nature of their wounds. Facially-wounded men – unlike amputees – could not ordinarily occupy an honourable public space because their wounds were too harrowing: many could not show their faces to their own families and were unable to look at themselves in mirrors. For the traumatized society these wounds, even when hidden behind masks, were too brutal to become incorporated into narratives of survival and healing. Despite celebrations of surgical ‘wizardry’ throughout the 1920s, facial injury remained a fierce taboo after the Great War and throughout the twentieth century.

For further information on facial injury see http://www.gilliesarchives.org.uk/.