This is Walter Yeo, an English sailor who was injured while manning the guns aboard the battleship HMS Warspite during the Battle of Jutland on May 31, 1916. Although the exact cause of his injuries is not documented, he was likely struck by flying shrapnel from an exploding shell and suffered burns from the accompanying hot gases. The blast left Yeo severely disfigured, with the loss of both his upper and lower eyelids.
Yeo was first treated at Plymouth Hospital before being transferred to Queen Mary’s Hospital, where he came under the care of Harold Gillies. Thanks to Gillies’ pioneering work in reconstructive surgery, Yeo received a ground-breaking facial graft. A flap of skin was transplanted across his face and eyes, and after several months of recovery, he was declared fit for active service once again.
Yeo was among thousands of soldiers who had their faces reconstructed during and following World War One. The Great War produced injuries in a scale and severity previously unseen, caused by weapons such as heavy artillery, machine guns, and poison gas. Facial wounds were especially common among soldiers in the trenches, who had to frequently peer over the parapet, exposing themselves to bullets and shrapnel. Hot, flying metal could rip through flesh with brutal force, leaving behind ragged wounds or even tearing away parts of the face entirely.
Facial injuries were difficult to treat on the front lines. Surgeons would sometimes stitch together jagged wounds without accounting for the amount of tissue that had been lost. As the scars healed, the flesh tightened, pulling the face into a permanent, grotesque grimace. Jaw injuries often left men unable to eat or drink, while some had to be nursed sitting upright to prevent suffocation when lying down. Others were blinded or left with a gaping hole where their nose had once been.
When these men returned home, they often faced stigma and isolation. Their disfigurements made it difficult to find employment, and many were relegated to working night shifts, away from public view. In some towns, they were made to sit on brightly painted blue benches in public spaces so that others knew not to look at them.
Fortunately, help came in the form of Harold Gillies, a New Zealand-born surgeon who had witnessed the carnage first-hand during his service at the front. Determined to find better solutions, Gillies dedicated himself to developing innovative techniques for facial reconstruction. Upon returning to England, he established a dedicated ward for facial injuries at the Cambridge Military Hospital in Aldershot.
Harold Gillies
However, the ward quickly proved insufficient to meet the growing demand. In response, a new facility was established at Sidcup— The Queen’s Hospital, which opened in June 1917 with over 1,000 beds. There, Gillies and his team developed many of the foundational techniques of modern reconstructive surgery. Gillies understood that healing a damaged face required more than simply covering wounds—it meant restoring both structure and function. His approach involved first repositioning any healthy tissue back to where it belonged. Then, gaps left by injury could be filled with tissue transplanted from other parts of the body. While surgeons already had some experience with skin grafts, Gillies refined these methods significantly. Once the underlying bone structure had been repaired, the team could begin the meticulous process of rebuilding the soft tissues of the face.
One of the most effective techniques developed by Gillies and his team involved the use of a “pedicle” graft—a large flap of skin that was partially detached from a donor site near the wound. The flap remained connected to its original blood supply at one end while the free end was carefully positioned over the injured area. This continuous connection ensured that the graft remained nourished, significantly increasing the chances of successful integration with the damaged tissue. Walter Yeo was among the first patients to benefit from this innovative method.
British and Indian wounded at Neuve Chapelle, on the way to the hospital base, 1915. Photo credit: National Army Museum
Note: For photographs showing facial injuries and the aftermath of surgeries, please use this link to visit the Imperial War Museum website. Please be advised these images are gruesome and too graphic to be included in this article.
Gillies continued to refine his techniques, often learning through trial and observation. A key breakthrough came during an operation on Willie Vicarage, a sailor who had suffered devastating burns in a fire during the Battle of Jutland. The injuries left his face fused into a tight, expressionless mask; he was unable to close his eyes or mouth.
To reconstruct the lower part of Willie’s face, Gillies proposed raising a “Masonic Collar Flap” from the skin on his chest. During the procedure, he observed that the edges of the skin flap—when stretched—tended to curl inward. To counter this, he stitched the edges together, forming a tube. This simple innovation dramatically improved the results: the tubular shape reduced the risk of infection and ensured a more reliable blood supply throughout the transfer.
Once the tubed pedicle had become firmly established near the injury site, it could be safely severed from the donor location. The tube was then opened and spread across the damaged area, allowing surgeons to cover much larger wounds than had previously been possible.
A wax teaching model showing Gillies’ surgical techniques. This model was prepared for the New Zealand Medical Corps facial and jaw injury unit, 1917. Photo credit: National Army Museum
These advancements by Gillies and his team not only transformed the lives of thousands of disfigured soldiers, but also laid the groundwork for the entire field of modern plastic surgery. The techniques he developed would go on to influence generations of surgeons, extending far beyond the battlefield.
In the years following the war, Gillies continued to push the boundaries of what reconstructive surgery could achieve. His expertise attracted patients from across the globe, and during the Second World War, he once again led efforts to treat injured servicemen. Yet perhaps one of the most remarkable chapters in his career came later, when he quietly broke new ground in the field of gender-affirming surgery.
In 1946, Gillies performed one of the world’s first documented gender-affirming surgeries, helping Michael Dillon—assigned female at birth—transition to male. A few years later, he also assisted in one of the earliest male-to-female procedures. At a time when such interventions were both socially taboo and medically uncharted, Gillies approached these cases with the same care, curiosity, and compassion that had defined his work with wounded soldiers. In doing so, he helped lay the medical and ethical foundations for gender-affirming care today.
From the shattered faces of war-torn soldiers to the lives of transgender pioneers seeking to live authentically, Gillies' legacy is one of healing, innovation, and humanity. His work reminds us that medicine, at its best, is not only a science—but an art deeply rooted in empathy.
References:
# The Birth of Plastic Surgery, National Army Mueum
# Meet Harold Gillies, the WWI surgeon who rebuilt the faces of injured soldiers, Ars Technica
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