Thanks to Netgalley and FSG for the ebook. Harold Gillies is a doctor working for the British military during World War One. He basically refines plastic surgery as we know it today as he tries to bring back the shattered faces of the many soldiers that come and stay at his hospital as Gillies invents one method after another, through painful trial and error, to try and give these men a sense of healing. It’s also a great short history of the war. While harrowing at many turns, Gullies is so innovative, and unfailingly decent, that you would follow his story in a book twice as long.

During the pandemic, in the months when the faculty and staff were working from home, I worked my way through all of the episodes of ER and Botched (among other shows). I was fascinated by the way medical knowledge advanced during the run of ER (1994-2009) and what the two surgeons on Botched were able to do for their patients to rebuild faces and bodies. Lindsey Fitzharris’s illuminating (and occasionally harrowing) account of the work of Sir Harold Gillies during World War I, The Facemaker, takes us back just over 100 years, to explore the dawn of plastic surgery. It turns out that some of the things the doctors on Botched do were pioneered by Gillies and his collaborative team of surgeons and dentists whereas others (like the use of ether and chloroform as anesthesia) are now seen as primitive. It’s even more remarkable when you know that this incredible, ground-breaking work was done as thousands of patients were pouring into Gillies’s hospital over four years of unceasing warfare on the Western Front.

Although Gillies practiced surgery before and after the war (Gillies died just a month after performing his last surgery), Fitzharris focuses her account on the war years, when Gillies and his team were constantly pushed to innovate. She opens by explaining that soldiers in World War I faced weapons that were much more dangerous, on a much bigger scale, than in previous wars. Poison gasses could kill, blind, and maim lungs in seconds. Machine guns were in every trench, ready for anyone to stick their heads over the top. Artillery produced massive craters in and out of the trenches that would obliterate anything in their path. And yet, at the beginning of the war, some armies sent their infantry into battle with flimsy helmets or no hard protection for their heads at all. The iconic Tommy helmets came a bit later. Conditions on the ground meant that, if a soldier was wounded, they were very likely to pick up infections before they could be rescued and sent to a hospital. Given the nature of the weapons they faced, it was little wonder that so many soldiers suffered catastrophic injuries that also required their doctors to learn, almost on the fly, radical techniques to treat their patients.

Fitzharris is incredibly good at condensing a lot of medical history in the chapters of The Facemaker. She can dip into medical history reaching as far back as Sushruta or briefly explain the history of blood transfusions and blood-typing to catch readers up on what they need to know to understand what Gillies et al. are doing with their surgical techniques. Plastic surgery (plastic in this case meaning shapeable or malleable) had been performed before World War I, but it was rare. Pre-anesthesia, pre-antisepsis, and pre- a lot of things we see as necessary for safe surgery, plastic surgery was very experimental before Gillies came to maxillofacial surgery. Fitzharris’ descriptions of Gillies’s techniques are clear. For readers who want more, there are archives of before, in-progress, and after photos of soldiers who had their faces rebuilt at Gillies’s hospital. Rebuilt is the right word. Some of the patients Gillies and his fellow surgeons saw were missing teeth, jaws, noses, eyes, and a lot of skin. Gillies and his team were able to rebuild faces from ruin.

It takes a remarkable kind of person to walk into unprecedented medical cases and think about what was possible, rather than focus on what they’d been taught was impossible. Gillies and many of the people he worked with during the war had the right mix of talents, thoughts, and personalities to work with patients who had been through physical and psychological hell. I’m glad Fitzharris retells Gillies’s story and the stories of several of his patients and colleagues; these stories should never be forgotten.

Advances in fire power and modern weaponry introduced horrors to the battlefield during World War I, and resulted in some of the most devastating injuries to the face and head, the likes of which had never before been seen by the physicians and medical staff serving at the front.

The Facemaker, by Lindsey Fitzharris, is the story of pioneering surgeon Harold Gillies who helped develop and legitimize the field of plastic surgery, and spent his war and post-war years attempting to restore and reconstruct the faces of the badly injured soldiers, sailors, and airmen of the British forces.

And while much of the book deals (rightly so) with Gillies and his progress in reconstructive surgery, Fitzharris also beautifully weaves the stories of some of his patients into the narrative. Using letters, diaries, and other primary sources, she creates lovingly detailed portraits that help reconstruct the lives of these damaged men. The result is a multi-layered, deeply human account that gives both Gillies and his patients a voice and a place in history as we learn how he and his team of dentists, sculptors, and artists worked together to restore confidence in their patients, and give these men back their lives.

The Facemaker is wonderful and really is the best kind of history book: fast-paced, dynamic, and highly readable (if horrific and rather gory at times, truly not for the faint of heart!) It is a story that allows a glimpse not only into the world of Harold Gillies and the historic path he forged, but into the lives of the people he saved.

I am so grateful to Net Galley for this ARC.

3.5 stars rounded up

I've been following Lindsey on Twitter for a while, and am always fascinated with what she shares there and her areas of scientific history exploration and interest. So I was excited to jump into this book that was about a huge moment in the history of plastic surgery.

The Facemaker is obviously extensively and lovingly researched. Fitzharris uses the work of Dr. Gillies to share the history of reconstructive surgical efforts, going back to antiquity at times, as well as diving into the complementary efforts of other medical professionals around him at the time that helped to create better processes for restoring facial disfigurations in soldiers. For example, chapter 2 focuses on a dentist, Valadier, who was instrumental in helping to determine some reconstruction techniques when it came specifically to the jaw.

While I found all of the information shared here fascinating and engrossing, there are two things that mainly hampered my enjoyment of this book. The first is a me thing. I expected more of a micro-history, very focused on particular cases of soldiers. The book instead is more of a broad and contextual look at the past and future of plastic surgery, in relation to WWI, and how the work that Dr. Gillies did was impacted and in turn affected the field. The other is that, for me, it felt a bit disorganized, and I think it could have used a heavier editing hand. For example, there were some repetitions in different chapters, of exact phrasing, or reintroducing something again that had already been introduced and explained earlier in the book. In that way, it felt kind of like a series of previously written pieces that were then attempted to cobble together. Like a jukebox musical: it sort of works, but some things just feel a little bit off.

The book is definitely not for the squeamish, as there are quite graphic descriptions of all kinds of battlefield injuries. These descriptions are important for context, and not gratuitous, but could be upsetting to some readers.

Overall, though, I feel more equipped to handsell this one now that I've read it myself and can help it find the right readers.

As a fun bonus, actor Daniel Gillies (of Vampire Diaries fame) is a relative of the doctor, and read the audiobook! I didn't listen to the audiobook but thought I would share this factoid I saw on Twitter in case someone wanted to read the book that way.

CW: gore, sexism

The Facemaker tells the story of pioneering plastic surgeon Harold Delf Gillies, who dedicated his life to reconstructing the faces of injured soldiers in his care during World War I. After reading The Butchering Art, Fizharris’ first book, I knew that I would want to read any future books that she wrote. This book surpassed my expectations and sucked me in from the very first page.

“[T]he science of healing stood baffled before the science of destroying.” quote from a battlefield nurse


Gilles had a remarkable dedication to his work. From the very beginning of the war he realized how facial wounds were being poorly treated and how it affected the soldiers. He was unwavering in his dedication to help these men and went about setting up a specific hospital for facial injuries and restoration. This eventually led to the establishment of the Queen’s Hospital in Sidcup that became the center of facial reconstruction during the war.

“These soldiers’ lives were often left as shattered as their faces. Robbed of their very identities, such men came to symbolize the worst of a new, mechanized form of war.”

Gillies not only realized the importance of reconstruction, but he also knew that it would take a multidisciplinary team for the work to be successful. He employed surgeons, physicians, dentists, radiologists, artists, sculptors, mask-makers, and photographers who all worked together to assist in the reconstruction process. This man was not only extremely creative with his blade, he also understood the importance of recording their work, hence the artists and photographers. Also, some of this art and photographs still survive today.

Learning about Gillies was fascinating, not only for his achievements but for the man himself. Gillies really was a compassionate and hardworking man. He went out of his way to make these men feel human, even when they only saw themselves as monsters. In the epilogue there are some quotes from the men he worked on and it really touched me to see how his positive outlook really impacted their happiness and recovery.

This book also briefly discussed the sculptors Francis Derwent Wood and Anna Coleman Ladd who created prosthetic masks for soldiers. I highly suggest looking up photos of Ladd and Wood’s masks because they are beautiful. You can really see the hard work these two put into making realistic masks for these men. This book also discussed brief achievements in anesthesia and blood transfusions, which was fascinating because I didn’t realize how much the war revolutionized the healthcare field.

“Men [who] save life never get the same appreciation and reward as those whose business it is to destroy it.” - quote from Sir William Arbuthnot Lane

Gillies had a very successful career after the war: In 1930 was knighted for his services during WWI, in 1949 he performed the first successful phalloplasty on a trans man, in 1946 he became the first elected president of the British Association of Plastic Surgeons, and he published two books about plastic surgery. Gillies also was pressed into service again during WWII. Harold Gillies lived a remarkable life that pushed the boundaries of surgery and changed the lives of so many people.

Overall, this was an absolutely fascinating book about a fascinating man. This was so well written that at times I almost forgot I was reading a nonfiction book. I highly recommend this book (or her other book) if you are interested in medical history.

Also, I love that she acknowledged the work of the archivist who discovered and preserved the clinical records from WWI while working at Queen’s Hospital. As an archivist myself, I love seeing authors acknowledge the hard work we do.

I received a free Advanced Reading Copy via NetGalley in exchange for a complete and honest review.
Super interesting and I absolutely loved how well it explained everything to someone who does not know all the details of plastic surgery!!

historical-figures, historical-places-events, historical-research, medical-treatment, surgical-history, WW1, war-is-hell, war-wounds, biography, nonfiction*****

War wounds have changed little since the nineteenth century, but the medical/surgical treatment and reconstruction have changed immeasurably. There was no reliable anesthesia, no antibiotics at all, effective feeding devices as well as IV fluids (especially plasma!) burn care/grafting, in conditions including mud/degrading gasses (info later applied to defoliants in later wars) of that war. There are bits describing work in the US during their Civil War, the early work in bone grafting, and the development/inclusion of dentists in the field hospitals. This is a detailed study of one dedicated surgeon's work which became the gold standard in maxillofacial surgery and reconstruction. It will be a tough read for veterans of wars, those injured in peacetime (car accidents etc.), and the highly imaginative. Me? Been there, seen that, cared for them as an RN.
I requested and received an e-book copy without illustrations (darn!) from Farrar, Straus and Giroux via NetGalley. Thank you!

This book was perfect for me. I love non-fiction books about the history of medicine. I loved Fitzharris' other book, The Butchering Art. If you like Mary Roach I think you will love The Facemaker and The Butchering Art. I think there is great balance of science and gruesome details. I don't think it would be overwhelming for people with little knowledge of medicine. I don't know what else to say other than I was never bored reading this book!