'This was a time when losing a limb made you a hero, but losing a face made you a monster'

Lindsey Fitzharris talks to Rhiannon Davies about her book on a pioneering plastic surgeon who rebuilt men's shattered faces during the First World War

- By Rhiannon Davies

Rhiannon Davies: Your book focuses on Harold Gillies, a surgeon in the First World War who made huge strides in facial reconstruction surgery. But how far back in history can we trace plastic surgery?

Lindsey Fitzharris: It pre-dates the First World War, so I don't want anyone to think that Harold Gillies is the father of plastic surgery as a whole. The term plastic surgery was coined in 1798. At that time, plastic meant something that you could mould and shape - so in this instance, a patient's skin or soft tissue. And attempts at early reconstruction of the face or to alter the appearance tended to focus on really small areas of the face. Rhinoplasty [reconstructing the nose] is one of the oldest surgical procedures on record, dating back to around 600 BC. It wasn't until the American Civil War that there were attempts to reconstruct the entire face, and even then it was quite limited.

How has facial disfigurement been viewed through history?

Disfigurement has been strongly associated with shame, because of its association with disease. Syphilis, which ravaged much of the world for centuries, caused saddle nose, where the nose would cave in. People associated syphilis - and the disfigurement it caused - with a moral failing. The other thing was that sometimes someone would be purposely disfigured as a form of punishment: people's noses were injured purposefully for sexual transgressions such as prostitution or adultery. And this stigma really continues even to today. If you look at Hollywood movies a lot of villains are facially disfigured, like the Joker or the Phantom of the Opera, and that's a really lazy trope to say that the person is evil or has some kind of moral failing.