Wednesday, January 22, 2014

Fixing the Face of War

When I got my nose cut on last year, the doc proposed doing what is called a "pedicle flap" to replace the divot. In other words, he would cut a slice of skin free from my forehead, leaving it attached at one end to maintain blood supply, and twist the other end down to cover the boo-boo on my nose. After a couple weeks to ensure it had taken, it would be cut loose from its old location on the forehead and everything would be tidied up.

The idea of running around for a few weeks with my nose connected to my forehead was sufficiently disturbing that I asked the alternative. "Well, we could just do a regular skin graft, but it might not take. That needs a good blood supply, and with the smoking..."

"My nose is bleeding like a fire hydrant right now, and I can quit smoking. What's the worst that could happen? The graft doesn't take and we have to make another run at it in a couple weeks with the flap thingy." Because, brrrr... I wanted to avoid the pedicle flap.

Then again, if my nose had been blown off by shrapnel, the pedicle flap might have seemed not such a bad thing. After all, there are boo-boos and then there are boo-boos.

All this to explain the fascination with which I read this BBC piece on the advances in facial plastic surgery made during the Great War. You might find it fascinating, too, but you'll want to make sure your breakfast is good and settled first. They apparently had those special blue benches around the hospital grounds for a reason.


Anonymous said...

FWIW, my grandmother did the pedicle flap when she had a bout with skin cancer on her nose. It looked bad during the process, but after it was all completed and healed, her nose looked better than before. We teased her about getting a nose job in her 70s. :)

Regarding the meat of the post, if one good thing has come out of this "War on Terror", it is the advances in reconstructive surgery and prosthetics.


Sport Pilot said...

Well that was pretty awful to view even after seeing just as bad in accident and assault victims. I'm full convinced that you have more raw determination and grit than a lot of other folks.

Phssthpok said...

How fortuitous. I have been wondering the last few days how your 'recovery' has been going, but didn't want to intrude on your personal space by inquiring.

Since you brought it up, though...I presume things are going well?

Paul said...

I once went into a face surgeon to get some of the stuff cleaned up on from an earlier event on my mug. He came in, took one look and left. And then billed me 50$ for the experience. Did not know I had that scary of a face. Oh well.

I did include a note in the bill about how if he did not feel up to the challenge I did not see any need to pay.

Last I heard from him.

War zones can make for some really horrendous visages.

David aka True Blue Sam said...

War; What Was So Great About It?

The Faceless Man
I'm dead.
Officially I'm dead. Their hope is past.
How long I stood as missing! Now, at last
I'm dead.
Look in my face -- no likeness can you see,
No tiny trace of him they knew as "me".
How terrible the change!
Even my eyes are strange.
So keyed are they to pain,
That if I chanced to meet
My mother in the street
She'd look at me in vain.
When she got home I think she'd say:
"I saw the saddest sight to-day --
A poilu with no face at all.
Far better in the fight to fall
Than go through life like that, I think.
Poor fellow! how he made me shrink.
No face. Just eyes that seemed to stare
At me with anguish and despair.
This ghastly war! I'm almost cheered
To think my son who disappeared,
My boy so handsome and so gay,
Might have come home like him to-day."
I'm dead. I think it's better to be dead
When little children look at you with dread;
And when you know your coming home again
Will only give the ones who love you pain.
Ah! who can help but shrink? One cannot blame.
They see the hideous husk, not, not the flame
Of sacrifice and love that burns within;
While souls of satyrs, riddled through with sin,
Have bodies fair and excellent to see.
Mon Dieu! how different we all would be
If this our flesh was ordained to express
Our spirit's beauty or its ugliness.
(Oh, you who look at me with fear to-day,
And shrink despite yourselves, and turn away --
It was for you I suffered woe accurst;
For you I braved red battle at its worst;
For you I fought and bled and maimed and slew;
For you, for you!......and it goes on if you look up Ballads of a Bohemian, by Robert Service.

Jennifer said...

Fascinating stuff.

armedlaughing said... ARE you healing?

I'm going in for my next skin doc check soon - it's been a couple years.
The half-dollar sized hole in the center of my forehead is healed. One only sees the imperfection in reflected light, no big deal.

I'm very grateful!


RKN said...

A colleague of mine had a pedicle flap stretched from a place near his ear, over his ear, after a minor surgery on the ear. I didn't see him during this time but the way his appearance was described to me, he might've passed for a Vulcan.

Tam said...

For those who asked about the nose, thank you. It's healed up okay, I'm told.

I'm hyper conscious of it, but that's probably because it's right there in the middle of my face.

Robin said...

We just want you healthy, Tam.

Hollowpoint1938 said...

Tam- I'm glad to hear you've healed. If you've stopped smoking, great! (former smoker and drinker.)

Steve C said...

As an alternative In the 1600's, there was the Italian method where the flap was taken from the upper arm. The arm was bandaged to the head while the flap was connecting. For a picture and an interesting site,

David aka True Blue Sam said...

What Robin Said...

Anonymous said...

Good to know! Keep smiling with your new beak!

Ulises from CA

staghounds said...

If there's a heaven, Gillies and McIndoe are there.

fillyjonk said...

I think I'd also take some pause at the idea of a pedicle procedure. (What matters is that you're healthy)

Some years back, Smithsonian magazine ran a similar story to the BBC one you linked - but it focused more on another strategy used in some of the worse cases - painted tin masks that the soldiers wore over the wounded area. I'm not sure that that wouldn't be more disturbing to the soldier's friends and family members - not really knowing the extent of the damage.

Knucklehead said...

Re: quiting smoking. First the old comment, "quitting smoking is easy. I did it dozens of times."

Following a small MI it was strongly suggested to me that I abandon that particular habit - for good.

The doc prescribed Chantix which I dutifully took for 3 days. It made me feel so shitty, like being internally infested with something doubleplus ungood, and getting worse and weirder each day, that I threw it out and went cold turkey from the weeds.

Just sayin', but it might be worth a try.

7+ years now. Rarely have cravings anymore but sometimes the old triggers, especially leaving work for the day, will induce one. Now they make me chuckle. They used to make me think of picking up a pack on the way home. That lasted about 3 or 4 years.

I am seriously glad I left that behind. Best of luck to you with that.

Tam said...


Haven't had a cigarette since... I dunno, whenever the surgery was last year.