When you look in the mirror you don’t just see a face. You see you.
So what happens when your face is disfigured? Thousands of people in the UK are affected by conditions from birth, or by diseases, conditions and accidents that happen later in life.
The world’s first clinical research centre devoted to facial surgery opened in London on Thursday.
But what’s in a face and how do people cope when theirs is ‘different’ from the rest of society?
“The thing about the face is that when you look in the mirror you say ‘that’s me’. “Whereas when you look at your hand you say ‘that’s mine’,” says James Partridge, chief executive of charity Changing Faces, which offers support for people with disfigurements.
“So much self-image is tied up with it. When we meet people, where do we look?
“We get so many signals from the face. For anyone who experiences damage, whether it be from birth, cancers, burns, skins conditions or paralysis, their whole signalling process will be affected.”
What influences someone’s ability to cope with facial difference is their self-belief and social support, he says, and not what has happened to them, when it happens in their life, nor the severity of the disfigurement, says Mr Partridge.
“Their capacity to deal with and manage other people’s reactions will also depend on their social skills.
Surgery can help, he says, but it is only one part of the package needed.
“Society today has strongly conditioned beliefs about ‘looking good’, which makes it doubly difficult for someone with disfigurement.
“But we believe very strongly that there will be a sea change in the population, that gradually it will become more okay to look different.
‘Emotionally crippled’
His view was echoed by a young woman who took part in a BBC Two documentary on facial disfigurement last year.
At the time Vicky Lucas, who has a genetic disorder called Cherubism, told BBC News Online what made her unhappy was not her face but the way people treated her because of it.
Having opted out of surgery she said: “My face is integral to who I am.”
Other cultures revere characteristics we consider unattractive, such as scars and wrinkles, continues Mr Partridge.
“Our cosmetic culture gives an enormously strong message that if we don’t have the ‘right’ sort of looks we won’t be successful. We know that’s rubbish, but we are trying to help people change those conditioned beliefs,” he adds.
People coming to the charity will most commonly talk of strangers staring, teasing, being rude, making comments in public places, and of their anxieties about the school playground or job interview.
They will often believe they have little chance of ‘making it’ in the world, he says.
Specialists involved in the new Facial Surgery Research Foundation which opened on Thursday also plan to carry out research into the psychological effects of having a facial disfigurement.
Iain Hutchison, a consultant in oral and maxillofacial surgery who is leading the project, said: “The face is central to how we are judged and how we feel about ourselves.”
But not surprisingly the issue is incredibly complex.
“We can treat people with really severe facial injuries, and not achieve perfect results, who are really powerful, confident people at the end of it.
“There are also people who have immense psychological problems after what we would consider a simple injury, but they are emotionally crippled for the rest of their lives,” he said.
“We form our character from our face. From a young age we will look in the mirror and practice with the way we look. We’ll move our face around and see what looks best.
“The reality of life is that how your face looks is an issue. We should be educating people, showing them that someone with a disfigurement can be highly intelligent, powerful, delightful; that they’re not monsters.”
[Reproduced from BBC News, 10th June 2004]