The Tin Noses Shop

Images of a WWI Soldier with a Facial Disfigurement and with a Facial ProsthesisSmithsonian Magazine’s February 2007 issue has a fascinating article called Faces of War which discusses methods of dealing with the devastating facial disfigurements suffered by soldiers who fought in World War I, and the medical personnel and artists who first pursued ‘modern’ facial prosthetic techniques.

Francis Derwent Wood, a sculptor who enlisted in the Royal Army Medical Corps, pioneered the use of thin metal as facial prostheses, instead of the cumbersome rubber previously used. While doing a stint as an orderly at London’s 3rd General Hospital, Wood began the work that developed into the “Masks for Facial Disfigurement Department”. The soldiers who frequented the department dubbed it the “Tin Noses Shop”; Wood’s artistic and technical talents allowed them to continue their post-war lives with realistic, if immobile, facial prostheses.

Inspired by Wood’s work, another sculptor, Anna Coleman Watts, a well-to-do Bryn Mawr, Pennsylvania native who had married an American-Red-Cross-connected physician, opened her own “Studio for Portrait Masks” in Paris where she and her assistants labored to make ‘life-like’ masks of paper-thin galvanized copper.

In Ladd’s studio, which was credited with better artistic results [than was Wood’s], a single mask required a month of close attention. Once the patient was wholly healed from both the original injury and the restorative operations, plaster casts were taken of his face, in itself a suffocating ordeal, from which clay or plasticine squeezes were made.

Ladd’s masks were laid over the face and held in place with earpieces attached to eyeglasses; like Wood’s, they were tinted to match the recipient’s skin, and carefully painted to resemble pre-injury photographs.

The Parisian studio produced only 185 masks in the year or so that it was operational. Though that figure seems almost inconsequential in comparison to 20,000 “facial casualties” the magazine reports, the difference they made to the men who owned them must have been significant far beyond mere numbers.

In a companion piece, Rivaling Nature, the author notes that

. . . wearers of prosthetic faces confront many of the same drawbacks today as in World War I. Breath moisture creates problems, steaming up glasses and interfering with adhesives; and even the most sophisticated prosthesis does not move.

Animation is only part of the story, though. While prostheses in general solve a range of problems, they also pose a host of others. As both articles indicate, the problems involved in producing realistic facial prostheses have not changed much since World War I.

Even modern materials like the silicone used for contemporary limb comesis and the fantastic robotics that make larger prosthetics function well are not subtle enough to allow realistic reproduction of facial animation, or sophisticated enough to resolve these other issues. Says one researcher:

“My patients would probably try it, and then never wear it,” says Donaldson of a full-face robotic mask. “What if it breaks? You’re back to square one.” Unless a patient is missing actual facial parts, Donaldson advocates confronting the world with the face that remains. “It’s society that should change,” she says. “It’s the public that needs to be educated.”

Plus ça change, plus c’est la même chose; it’s still, it seems, a long way to Tipperary.