Harold Gillies: The Man Who Rebuilt Faces
The Somme sent back men whose faces were gone. Machine guns and shrapnel at close range destroyed jaws, noses and eye sockets in ways that nineteenth-century surgery had no answer for, and the survivors were hidden. At the Queen's Hospital in Sidcup, a New Zealand-born ear, nose and throat man and his colleagues performed more than 11,000 operations on over 5,000 of them. Harold Gillies did not merely repair the wounds. He invented the discipline that repairs them.
Dunedin, Cambridge, and Three Golf Blues
Gillies was born in Dunedin, New Zealand, on 17 June 1882, the son of Robert Gillies, a Member of Parliament for Otago. He was educated at Whanganui Collegiate School and then read medicine at Gonville and Caius College, Cambridge. A childhood accident had left him with a stiff elbow, which appears to have inconvenienced him not at all: he took golf blues in 1903, 1904 and 1905 and rowed in the 1904 Boat Race. He was also a freemason, eventually Master of the Caius Lodge.
He trained at St Bartholomew's Hospital, won the Luther Holden Research Scholarship in 1910, and went into ear, nose and throat surgery — a specialty that, as it happened, gave him unusual familiarity with the architecture of the head.
Wimereux and Paris
He enlisted in the Royal Army Medical Corps in 1915 and was posted to Wimereux, near Boulogne, where he found himself assisting Auguste Charles Valadier, a French-American dentist working out how to repair shattered jaws. Valadier was experimenting with skin grafting, and Gillies saw the possibility. He went on to Paris to watch Hippolyte Morestin, the celebrated oral surgeon, remove a tumour from a patient's face and close the defect with skin taken from the jaw.
That was the entire education available. There was no textbook, no specialty, no trained cohort. Gillies came back to England and persuaded the army's chief surgeon, Sir William Arbuthnot-Lane, to open a ward for facial injuries at the Cambridge Military Hospital in Aldershot in 1916. Within months the Somme had overwhelmed it.
Sidcup
The Queen's Hospital at Sidcup opened in June 1917 with more than a thousand beds across its convalescent units. What Gillies built there was not just a surgical service but a method — a multidisciplinary centre in which surgeons, dentists, radiographers, photographers and artists worked on the same patient.
His central technical contribution was the tubed pedicle. A flap of skin was raised and rolled into a closed tube while one end stayed attached to its original blood supply, then walked in stages towards the injury. Because the tube was sealed and living, it carried its own circulation and resisted the infection that killed so many earlier grafts. It is the technique on which reconstructive surgery ran for decades, and the Royal College of Surgeons' archive of Gillies's case files documents it exhaustively.
Those files — covering over 2,500 soldiers, complete with rank, number, regiment and date of wounding — hold photographs, clinical notes, x-rays and watercolours. Henry Tonks, a surgeon who had left medicine to become a professional painter and teacher, made pastel portraits and face casts of the wounded, now held by the Hunterian Museum. The point of the artists was not sentiment. Gillies was operating for appearance as well as function, and he needed a record of what a face had been and what it had become.
He published *Plastic Surgery of the Face* in 1920, the founding text of the field. He was appointed OBE in 1919 and CBE in 1920, and knighted in the 1930 Birthday Honours.
Between and After the Wars
Gillies built a large private practice with Rainsford Mowlem and lectured internationally. In 1930 he invited his cousin Archibald McIndoe into the practice and pushed him towards a post at St Bartholomew's — the decision that produced the surgeon of the Guinea Pig Club and the burned airmen of the Second World War.
When that war came, Gillies served as consultant to the Ministry of Health, the RAF and the Admiralty, and organised plastic surgery units across the country: this time the specialty existed in advance of the casualties, because he had built it. He operated at Rooksdown House, part of Park Prewett Hospital near Basingstoke, and toured South America lecturing between 1941 and 1942 with the photographer Percy Hennell.
He did not retire afterwards, largely because he could not afford to. In 1946 he performed one of the first phalloplasties for a trans man, Michael Dillon. In 1951 he and colleagues carried out one of the first modern gender-affirming surgeries on a trans woman, Roberta Cowell, using a flap technique that remained standard for forty years. Asked about the work, he said simply: "If it gives real happiness, that is the most that any surgeon or medicine can give."
He married Kathleen Margaret Jackson on 9 November 1911; they had four children. He competed in the Amateur golf championship every year from 1906 to 1931, played for England against Scotland four times, and won the St George's Grand Challenge Cup in 1913 and the President's Putter in 1925. On 3 August 1960, operating on the leg of an eighteen-year-old girl, he suffered a cerebral thrombosis. He died on 10 September at the London Clinic, aged seventy-eight. He had earned around £30,000 a year between the wars and left an estate of £21,161.
Why Harold Is Called a Genius
Gillies is routinely called the father of modern plastic surgery, and the claim survives examination — but the quality involved is craft intelligence rather than theoretical brilliance, and it is worth being precise about that. He discovered no biological principle. What he possessed was an exceptional three-dimensional imagination for tissue: the ability to look at a destroyed face and see, in the surviving skin of a chest or forehead, the material for a nose and the route by which it could be moved there alive. The tubed pedicle is a plumbing insight — keep the blood supply attached, seal the surface against infection, move the tissue in stages — and its elegance lies in solving the two problems that had defeated everyone before him at once.
The second and less celebrated part is organisational. Gillies had almost no precedent: two afternoons watching Valadier and Morestin, and a war's worth of injuries nobody had ever attempted to repair. He built a specialty from that — a hospital, a team of artists and photographers and dental surgeons, a documented archive of over 2,500 cases, and a textbook — and then trained the men who took it forward, McIndoe among them.
The honest qualification is that he was not alone. Valadier and Morestin preceded him; Sidcup was a large collaborative operation; skin grafting long predated him. His genius was synthetic and practical, exercised with a scalpel and an eye, and its measure is not an idea but thousands of individual faces that could be shown in public again.
Legacy
A blue plaque marks his house at 71 Frognal in Hampstead; Gonville and Caius named Gillies Close for him in 2015, and Gillies Lane at Gun Hill Park in Aldershot commemorates him too. The Royal College of Surgeons holds his patient files and the Hunterian Museum holds Tonks's portraits of the men he treated. Every reconstructive procedure performed today on a burn, a cancer resection or a road accident descends from the ward he talked the army into opening at Aldershot in 1916 — and so, more quietly, does the surgical care of trans people, which he undertook in the 1940s when almost no one else would.
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