WEBVTT - How Did Early Facial Prostheses Work?

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<v Speaker 1>Welcome to Brainstuff, a production of iHeart Radio, Hey, Brainstuff,

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<v Speaker 1>luring Vogel bomb here. What could you do to help

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<v Speaker 1>those fighting in a brutal war? At some point in history,

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<v Speaker 1>whole nations of individuals have had to ask themselves that question.

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<v Speaker 1>They've rationed food and supplies, restructured their careers, nursed the

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<v Speaker 1>wounded soldiers themselves, and monitored their own everyday speech. During

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<v Speaker 1>World War One, an American woman named Anna Colwyn Ladd

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<v Speaker 1>used her skills as an artist to change the lives

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<v Speaker 1>of men disfigured in the war. World War One was

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<v Speaker 1>fought differently from any war that preceded it. The twentieth

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<v Speaker 1>century brought with it the fruits of the Industrial Revolution,

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<v Speaker 1>which in this case included machine guns. Soldiers were often

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<v Speaker 1>dodging a hailstorm of bullets rather than single shots, along

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<v Speaker 1>with artillery which involved lots and lots of shrapnel. Around

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<v Speaker 1>twenty one million men were injured in the war, and

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<v Speaker 1>some of them lost chins, noses, lips, and cheekbones, not

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<v Speaker 1>surprising since trench warfare involved a lot of looking up

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<v Speaker 1>over the edge of the trench to see if the

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<v Speaker 1>coast was clear. Facial reconstruction surgery was a brand new

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<v Speaker 1>technology at this time, and though some of its practitioners

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<v Speaker 1>had experience restoring or recreating faces on a small scale,

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<v Speaker 1>these surgeons were suddenly presented with the then impossible task

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<v Speaker 1>of reconstructing entire faces. The men would survive, but the

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<v Speaker 1>trauma of such damage was grim. Anna Coleman Lad was

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<v Speaker 1>an American sculptor from Boston who moved to France during

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<v Speaker 1>World War One so that her husband could take a

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<v Speaker 1>position with the Red Cross. After learning about the plight

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<v Speaker 1>of these men, she corresponded with English sculptor Francis derwent Wood,

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<v Speaker 1>the founder of the Tin Noses Shop in London, where

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<v Speaker 1>he made tin masks for soldiers with facial mutilations. Then,

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<v Speaker 1>with the help of the Red Cross, Lad set up

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<v Speaker 1>her own studio in Paris, called the Studio for Portrait Masks.

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<v Speaker 1>Lad turned out to have a real gift for crafting

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<v Speaker 1>portrait masks, precursors to today's facial prostheses. The masks were

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<v Speaker 1>created to cover just the damaged portion of the soldier's face,

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<v Speaker 1>which could of course, sometimes include the entire face. Lad's

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<v Speaker 1>work was lauded as the best of its kind, and

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<v Speaker 1>each mask took months to produce. In order to create

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<v Speaker 1>a mask that resembled each man's pre war face as

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<v Speaker 1>closely as possible, Lad first required photos of the original face,

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<v Speaker 1>and after the wounds from the injury and any subsequent

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<v Speaker 1>surgery healed completely, she and her team got to work.

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<v Speaker 1>She took a plaster cast of the entire face and

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<v Speaker 1>from there made squeezes, clay or plast seen copies of

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<v Speaker 1>the face on which Lad could base her portrait recreation work.

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<v Speaker 1>The masks themselves were made from very thin gall of

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<v Speaker 1>anized copper, about the thickness of the cover of a paperback,

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<v Speaker 1>and they were usually held in place with spectacles. Lad

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<v Speaker 1>painted each mask with enamel while the man was wearing

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<v Speaker 1>it so she could get the best possible skin tone match.

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<v Speaker 1>Facial hair like mustaches, eyelashes, and eyebrows were added at

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<v Speaker 1>the end with real hair. Although lad Studio was only

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<v Speaker 1>open for a year, she and her four assistants created

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<v Speaker 1>a hundred and eighty five masks which changed the lives

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<v Speaker 1>of her clients. They reported being better able to live

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<v Speaker 1>with their families, get jobs, and feel as if they belonged,

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<v Speaker 1>rather than hiding away feeling monstrous in a veteran's home.

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<v Speaker 1>Lad was a pioneer in facial prosthetics, and her results

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<v Speaker 1>were remarkable, even though the masks she made were fragile

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<v Speaker 1>and easily battered, and they didn't restore movement and function

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<v Speaker 1>to the face. These days, facial pross theses are used

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<v Speaker 1>in situations in which surgical reconstruction isn't technically possible isn't

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<v Speaker 1>recommended for the patient for other reasons. For the article,

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<v Speaker 1>this episode is based on How Stuff Works. Spoke with

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<v Speaker 1>one Garcia, an anaplastologist at the Johns Hopkins Carnegie Center

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<v Speaker 1>for Surgical Innovation. He said there are many reasons why

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<v Speaker 1>a patient cannot have a surgical option offered to them.

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<v Speaker 1>A person missing an eye and eyelids cannot have this reconstructed.

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<v Speaker 1>Cancer patients who undergo radiation therapy do not heal well.

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<v Speaker 1>The surgical reconstruction of the ear and nose is very

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<v Speaker 1>delicate surgery, oftentimes leading to a poor aesthetic outcome, even

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<v Speaker 1>in the hands of a skilled surgeon. Modern anaplastologists still

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<v Speaker 1>work with plaster in paint, but they use modern dental

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<v Speaker 1>materials like resin daie stone, an ultra strong form of

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<v Speaker 1>gypsum that behaves a lot like plaster along with paints

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<v Speaker 1>mixed with silicone. Garcia said, unlike the painted, rigid masks

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<v Speaker 1>made of copper that Lad made, we generally sculpt the

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<v Speaker 1>prosthetic device in wax before the stone mold is made

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<v Speaker 1>to cast a saw flush like silicone prosthesis. These days,

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<v Speaker 1>we used advanced digital technologies such as surface scanning, digital sculpting,

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<v Speaker 1>and three D printing, and implants in the form of

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<v Speaker 1>titanium screws, similar but shorter than dental implants. These screws

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<v Speaker 1>are placed into the bone by a surgeon and can

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<v Speaker 1>be used to hold the prosthesis in place. So nobody's

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<v Speaker 1>holding their prosthesis on by dangling it from spectacles anymore.

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<v Speaker 1>But Lad paved the way for a lot of the

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<v Speaker 1>good work anaplastologists do today, and the outcome is largely

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<v Speaker 1>the same. Garcia said. The work of the anoplastologists allows

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<v Speaker 1>patients to get back to their work, family, friends, and

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<v Speaker 1>activities they enjoy. It allows them to move forward with

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<v Speaker 1>their lives with a renewed sense of normalcy, albeit a

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<v Speaker 1>new normal. Hopefully the work goes undetected. However, the main

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<v Speaker 1>goal is to help the patient move from an isolated

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<v Speaker 1>and perhaps ostracized state to one where they can once

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<v Speaker 1>again engage others. Today's episode is based on the article

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<v Speaker 1>how a lone sculptor gave New Faces to injured soldiers

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<v Speaker 1>of World War One on how stuff works dot Com,

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<v Speaker 1>written by Jesslyn Shield. Brain Stuff is production of I

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<v Speaker 1>Heart Radio in partnership with how stuff Works dot Com,

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<v Speaker 1>and it's produced by Tyler Klang. For more podcasts, in

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<v Speaker 1>my Heart Radio is at the heart Radio app, Apple Podcasts,

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<v Speaker 1>or wherever you listen to your favorite shows.