ENGWe restore the faces of people who have suffered injuries in the war. Inside the operation room

Ihor Liubarskyi

soldier, injured in 2021

I’m 26, I’m from Kirovohrad Oblast. I used to be a farmer and a hunter. When the war started, all that fell away. My father went to war in 2014, but I couldn’t then because of my age. As soon as I turned 18 in 2015, I also went. My only motivation is to defend my country. Remember Genghis Khan? His strategy was to seize tiny bits of one province, and then the next, until he was in control of huge territories. He only managed to do it because he faced no collective resistance. If the war is in Donbas, it doesn’t mean that only people from Donetsk Oblast should be the ones defending Ukraine. Everyone has to come together and drive out the enemy. I don’t want them to make it all the way here, to where I’m at – I’d rather go fight them there.

Everyone in my unit thought that way. We were like family to each other, everyone served for at least 5-6 years. For years, I had to share my bed with two other soldiers. I learned a lot. Google, YouTube – there’s so much information on there, you can learn so much. Saying that you have to go somewhere for training is just an excuse made by lazy people. If you want, you can teach yourself all you need to know to be in the military, and quicker than any training center would teach you, at that. A friend of mine is a gunner. He learned how to operate a KPV heavy machine gun in two weeks, by watching YouTube videos – and then taught these people who’d spent two months at a training center supposedly learning the same thing.

On the front, we carried out combat engagements. Two years ago, on the 30th anniversary of Ukraine’s independence, we wanted to do something nasty to the Russians: we thought we’d quietly approach them from their rear, but a Russian sniper spotted me, and fired three times. He must’ve been a bad sniper – normally, three shots is enough to kill someone. My arm, shoulder, and head were injured. That’s how that day went.

I stayed conscious for about three hours, then spent the next 10 days or maybe even two weeks in a coma. I was in and out of hospitals, going through a lengthy treatment process. First I was in Sievierodonetsk, then I was taken, by helicopter, to Kharkiv, then from Kharkiv to Kyiv. I had more surgeries in Kyiv. They did so many things – there were so many surgeries.

There’s one in particular I remember. They couldn’t insert a cannula to administer anesthesia, so I stayed conscious. I watched them perform the surgery, it was pretty fun, though the operation table was hard and my lower back hurt – I couldn’t bend my legs, and had to stay in the same position for six hours. I got so fed up with all those hospitals, eventually they’d induce panic in me. I was asked if I wanted to get treated abroad, they wanted to get me a shoulder prosthesis, but doctors at the Institute of Traumatology and Orthopedics said I’d be better off without the procedure. Having a prosthesis would mean I wouldn’t be able to put any pressure on my shoulder, so I wouldn’t regain my ability to move it. They wondered if it would be possible to take some muscle from my back and graft it onto my arm, but that seemed unlikely.

The surgery on Ihor’s face at the New Body Plastic Surgery Clinic in Kyiv’s Podil district lasted about five and a half hours.

First, surgeons partially removed the plates that were installed in his face the year he was wounded, when he received first aid.

They then prepared the tissues and installed a new custom-made implant, which was developed specifically for Ihor from a special type of polyester, a bioinert plastic that allows for complete tissue inertness.

For some time now, surgeons have been using this material in custom implants, but in the past these implants were smaller and interacted with smaller parts of people’s bodies.

Custom-made implants are made based on a CT scan, and a software models the implant based on the healthy side of the face, the intact parts of the skull. The implant is then made on a 3D printer.

Ihor’s case is also unique for Ukrainian plastic surgery because a large, two-part implant like his has never been installed in the zygomaticomaxillary complex part of the skull in Ukraine before, the surgeons at New Body say.

Early in the full-scale invasion I felt that I had to help Ukraine with more than just donations. I’m familiar with the issues facial injuries bring up, because I had a similar experience. I suffered a third-degree burn and underwent seven plastic surgeries. When I meet people with damage to their faces, it affects me really profoundly.

What triggered me for the first time was seeing a young woman whose face was disfigured in the [Russian] missile strike on [Amstor,] a Kremenchuk shopping mall. I felt her pain and I wanted to help her. That was when I realized that I wanted to help Ukrainians who’d suffered similar injuries. I have substantial experience as an organizer, first-hand experience with this issue, and professional contacts among reconstructive plastic surgeons.

How it all started

I first turned to the doctors I knew, the ones who treated me. But at first it was quite chaotic, we couldn’t find a constant source of support, someone who would be prepared to help us on a regular basis.

The first person to support us was Yevhen Shahov, a dermatologist. He is now our medical expert and coordinator. Some patients have their first consultation and rehabilitation procedure (laser resurfacing) in his clinic.

Yevhen has a lot of acquaintances in the aesthetic surgery field, which helped us a lot. I’m not a doctor myself, I only see the situation from the patients’ perspective. I have personal experience and a ton of mistakes I made in my time, as I was getting my face treated. Yevhen considers each case from a medical perspective. He knows who to turn to with different types of injuries. Together we developed an algorithm for this.

I had a budget which would’ve covered facial reconstruction surgery for three to five people. But Yevhen got other doctors and clinics involved in our project; they are offering free consultations and are prepared to treat people pro bono. They perform surgeries free of charge; we just cover the cost of supplies needed for those operations.

We needed an implant for Ihor’s surgery. Our partners from one of the clinics made it for us at cost. My goal is to put together a network of trusted partners prepared to help people [like Ihor].

When we launched, we laid out a set of principles for how we would decide who to work with, because we wanted to work with people who’d sustained injuries in the war. All injuries are critical and urgent, but it was important for us to focus on people who had been injured by bullets or shrapnel.

This is how things work now: you fill out a form on our website, attach a note from your hospital, and our project manager checks the information, before handing it over to the rest of the team. If one of our medical experts confirms that we can help, we take you on and start working with you.

For now, we lack expertise with some severe cases, for example ophthalmology, especially if prostheses are required. We had one very difficult case: I really wanted to help that person, but unfortunately we weren’t able to find an appropriately qualified specialist in Kyiv. We had to send them to Odesa – doctors there promised they’d be able to handle the case.

Once we have a treatment plan, we look at it and agree on it together , because we want you to know that this is a process that won’t be over in a matter of days or even months. It could last a year or longer.

We try to find people – men and women of different ages – for whom this is really important. I’m glad that we can work with a group of psychology professionals, people who specialize in trauma therapy. They put us in touch with specialists prepared to work with our patients. Unfortunately, not all patients are ready for this, but we encourage them and explain that this could be a crucial addition [to physical therapy].

Most of our budget comes from my personal savings, but friends and team members also contribute

That’s why having an injury that affects your appearance might totally disorient you, make you feel like you’re losing your footing and your sense of self. It might seem like the feelings you’re experiencing will stay with you forever. You might feel stuck and not see a point to anything; everything changes, including your life goals. It might seem that everything you dreamt about, everything you’d planned is now over and is no longer possible. It might seem that what happened to you is irreversible and your life is over. You might feel despair, pain, anger. But those feelings are normal in these circumstances.

What’s really important is how we respond [to people suffering that trauma], how we help them. We have to support them, to understand that the emotions they are experiencing are not a sign of their weakness but a natural response to the situation they’re in. But this is not forever, things will change. It’s important to just be near and listen to them. It’s very important for someone in that state to have someone who will listen to them.