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Plastics
Pioneers of plastic surgery: the story of Kiwi innovation over the war years (Part 2)
Across two world wars, the groundbreaking work of this small group of New Zealanders, developed on the battlefields and in wartime hospitals, not only redefined surgical practice but also laid the foundation for a new medical specialty.
Read Part 1 about pioneers of plastic surgery here.
The father of modern plastic surgery: Sir Harold Gillies
Sir Harold Delf Gillies (1882–1960), regarded as the father of modern plastic surgery internationally, described the emerging field of plastic surgery as a “strange new art.” Confronted with the severe facial injuries of WWI soldiers, Gillies—supported by a multidisciplinary team—developed innovative surgical techniques that remain foundational today. With characteristic reassurance, he told his patients, “Don’t worry sonny, you'll be alright and have as good a face as most of us before we're finished with you.”
Initially training in ENT (ear, nose, and throat) with Sir Milsom Rees at St Bartholomew’s Hospital in London, Gillies volunteered to join the French Red Cross when war broke out. He wrote, “I realised that I had struck a branch of surgery that was of intense interest to me.” His interest in facial reconstruction deepened while working with French dentist Auguste Charles Valadier, who introduced Gillies to bone grafts - a crucial procedure Gillies would heavily use. Later, in Paris, he trained under renowned facial surgeon Hippolyte Morestin. “I fell in love with the work on the spot,” Gillies wrote of that time. This set him on a path to create the UK’s first facial injury unit at Cambridge Military Hospital in 1916.
Gillies brought artists and sculptors into the operating theatre to document his procedures; thought to be less obtrusive for patients than photographers. He later reflected on the daunting nature of early plastic surgery: “Unlike the student today, who is weaned on small scar excisions and gradually graduated to a single harelip, we were suddenly asked to produce half a face. All this time, we were fumbling towards new methods and new results without the boon of sulfa drugs, plasma, or penicillin.” Gillies devised numerous groundbreaking methods, including tubed pedicles, the bishop’s mitre flap, and an adaption of Johannes F. Esser's epithelial inlay technique to create a new eyelid for a patient. This last would prove crucial for burn victims in WWII. Many of Gillies methods were developed during WWII by his cousin, Sir Archibald McIndoe, and continue to shape reconstructive surgery today.
"I realised that I had struck a branch of surgery that was of intense interest to me. I fell in love with the work on the spot." - Sir Harold Gillies
Forming the Guinea Pig Club: Sir Archibald McIndoe
Sir Archibald Hector McIndoe (1900–1960) transformed the field of wartime plastic surgery with both surgical innovation and an empathetic focus on psychological recovery. Treating badly burned RAF aircrew during WWII, McIndoe championed early social reintegration for his patients, who later formed the Guinea Pig Club—a lifelong network that celebrated both survival and camaraderie under his care.
A graduate of Otago Medical School and the first New Zealander to earn a Mayo Clinic Fellowship in the USA, McIndoe arrived in London to find a promised job didn’t exist. Fortunately, distant cousin Sir Harold Gillies invited him into his plastic surgery practice, where they treated disfigured children, trauma victims, cancer survivors, and RAF officers with scarring from sandfly fever. With the outbreak of WWII, McIndoe became a civilian consultant plastic surgeon for the RAF. McIndoe reflected, “Historically there was little to guide one in this field [of the total reconstruction of the burned face] apart from the general principles of repair… There had until then been no substantial series of cases published and none in which a rational plan of repair had been proposed.”
Faced with unprecedented burn injuries from air combat, McIndoe rejected harmful treatments like tannic acid that had been used to promote coagulation at the burn site to create a scab. He developed an alternative option; using loose-weave dressings with a greasy product such as Vaseline applied to the trauma site and sterile dressings placed on top, promoting healing and surgical readiness. His patient-centred methods revolutionised care and required dedicated support staff to manage the intensive work. As wounded airmen flooded into East Grinstead during the Battle of Britain, McIndoe and this groundbreaking plastic and maxillofacial unit became a household name. His medical and moral commitment meant that nearly 80% of his patients returned to flying, and more importantly, to daily life—with dignity, purpose, and public acceptance.
Developing maxillofacial surgery: Henry Pickerill
Though perhaps less widely known than some of his contemporaries, Henry Percy Pickerill (1879–1956) played a crucial role in the development of maxillofacial surgery during WWI. An exceptional academic and skilled surgeon, Pickerill took a non-traditional path through the medical profession—one that may have limited his acceptance among peers, but not the significance of his contributions. His legacy stands alongside that of Gillies in the early advancement of reconstructive surgery.
Born in England where he studied medicine and dentistry, Pickerill was closely connected to New Zealand. Remarkably, while still in his twenties, he became the first director of the newly formed School of Dentistry at the University of Otago. There, he gained national acclaim for championing dental health and advancing surgical techniques for treating facial deformities, including cleft palate and jaw realignment procedures—work that laid the groundwork for his wartime innovations.
Note regarding the below: Archival materials can contain sensitive content that may be upsetting. Some items may include images, information, or language now considered outdated and offensive. Please be aware of this when accessing them.
Credit for first six images below: Ref PA1-o-467, Alexander Turnbull Library, Wellington, New Zealand. Copy of an album containing photographs of some specimens of plastio facio-maxillary cases of the New Zealand section, Queen's Hospital, Sidcup, Kent, England. Image reproduced with permission.
In 1916, Pickerill was sent to England to join the Second New Zealand General Hospital at Walton-on-Thames, where he established a specialised unit for jaw and facial injuries. His collaboration with Gillies began in 1918 when his team was transferred to the Queen’s Hospital at Sidcup, treating soldiers from across the Allied forces. After WWI he returned to Dunedin, completing surgical reconstructions for returned servicemen and continuing his academic work. During WWII, alongside his wife Cecily, Pickerill undertook plastic surgery at Wellington Hospital and their private clinic, Bassam in Lower Hutt, where they treated most of the country’s infant cleft palate cases. Their work extended to plastic surgery for civilians at Burwood military hospital and regular clinics at Middlemore Hospital into the late 1940s—cementing the Pickerills’ place in the evolution of plastic and maxillofacial care in New Zealand.
Read Part 1 about pioneers of plastic surgery here.
Read Part 3 here.
Dr Earle Brown FRACS FRCS is a well-known plastic surgeon who, before retiring from practice in Aotearoa New Zealand, played a role in the development of plastic surgery in our country. He is the former Head of Unit and Consultant Plastic Surgeon, Middlemore Hospital, New Zealand.
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Find out more about the history of plastic surgery.
Read about New Zealand’s contribution to plastic surgery and the origins of the word ‘Plastic’.
Read about Sir William Manchester’s role in the establishment of plastic surgery in New Zealand.
Discover the work of Sister Joyce Walters in the establishment of the New Zealand plastic surgical nursing service.
Skin deep: unveil the secret superpowers of your body’s largest organ.
Planning is of the essence: read Part 1, Part 2, and Part 3 of a summary of reconstructive surgery techniques.
Find out about war photography of plastic surgery: read Sandy Callister’s article, ‘Broken Gargoyles’: The Photographic Representation of Severely Wounded New Zealand Soldiers in Social History of Medicine Vol. 20, No. 1 pp. 111–130.