Masks: The Face Transplants of World War I

One hundred years ago today, Britain declared war on Germany, thereby entering World War I. The day before, Germany had declared war on France. Before long, the world's nations would be pitted against each other in a grueling conflict that would eventually take the lives of more than nine million soldiers.

The iconic trenches of World War I were themselves an "unforeseen enemy," though. The unceasing machine-gun fire led to a fate that was, at the time, almost as bad as death. Western front soldiers who popped their heads above their trenches would come back down with a nose, jaw, or even an entire face missing.

When these so-called mutilés returned home, surgeons were met with the overwhelming task of treating scores of men who were barely recognizable to themselves or their families, at a time when the most advanced cosmetic procedure was repairing a cleft lip.

It didn't help that the prevailing sentiment a century ago was that losing part of one's face meant, in a way, a change of identity. In the U.K., "very severe facial disfigurement" was one of the few injuries for which a soldier received the full pension—the thinking being that it compromised one's "sense of self and social existence," as the historian Suzannah Biernoff explains. Newspapers at the time said the veterans "are almost condemned to isolation unless surgery can repair the damage."

According to a great Smithsonian magazine article on the subject, in Sidcup, England, a town that was home to a hospital for WWI soldiers, the nearby benches were painted blue, "a code that warned townspeople that any man sitting on one would be distressful to view."

"The psychological effect on a man who must go through life, an object of horror to himself as well as to others, is beyond description," recalled Fred Albee, an American surgeon working in France. "It is a fairly common experience for the maladjusted person to feel like a stranger to his world."

In a time before transplants, the task of repairing these broken faces was largely left to masks. And the person who made some of the best masks, by all accounts, was a sculptor named Anna Coleman Ladd. Along with Francis Derwent Wood, an artist and captain working in London hospitals, Ladd is credited with helping hundreds of maimed veterans re-adjust to society.

In her Studio for Portrait Masks in Paris, Ladd would take plaster casts of a soldier's face in an attempt to re-create an identical cheekbone or eye-socket on the opposite side. Ladd then crafted a full or partial mask out of copper, which she painted to match the skin while the soldier was wearing it. The entire piece, weighing roughly half a pound, was either tied to the head with strings or hung from a set of eyeglasses. 

Eventually, she honed her technique to the point where she could create the casts from images or photos of the men before their disfigurement. Of the nearly 3,000 or so French soldiers requiring such masks, Ladd made about 185. In 1932, the French government made her a Chevalier of the Legion of Honor.

Despite her patients' seeming gratitude—one wrote Ladd to say that he was thankful that his wife no longer found him repulsive—Ladd noticed that the masks would fall apart after just a few years. None of her masks survived to the present day.

The recent GQ piece on Richard Norris, a man who had a full-face transplant in 2012 after a shotgun accident, shows just how far facial reconstruction technology has come. The stigma and psychological wounds these individuals encounter, though, remains similar: Just as in the facial-reconstruction hospitals of early 20th-century France, prior to his surgery Norris had reportedly covered all the mirrors in his house.