How 3D printers help reconstruct faces of wounded Ukrainian soldiers

Oleksander Didur wears the war on his face. In the scars that ripple across his forehead and chin. In his left eye socket, still higher than the right, even after many surgeries.

And in the bright green of the prosthetic eye he chose not to match his natural brown but to highlight the mark the war left on him; to announce his injury without fear or shame.

“I chose jade because I wanted to draw attention to what had happened, not to hide it,” Didur, 32, said at the clinic in Kyiv where he counsels other soldiers who have suffered life-changing injuries. “I wanted to show people that the war is still going on, it’s real, it’s here and you can’t wish it away.”

Two and a half years after the Russian invasion began Ukraine is battling a tidal wave of wounded, including more than 50,000 amputees. Far less talked-of is the number who have lost their vision or their faces, many of them too ashamed and traumatised by their appearance to stand in plain sight.

At the Imateh Medical clinic, in Kyiv, high-tech solutions are being found for war wounds that are often more reminiscent of conflict a century ago.

A constant hum and buzz emanates from the room where 3D printers are at work, seamlessly translating scans of wounded skulls into implants and prostheses used to rebuild shattered faces. Others conjure into being the damaged skull itself, providing a model on which to build a new eye, a new cheek. It has been a steep learning curve for everyone here since President Putin sent his troops over the border in February 2022.

As many as a third of Ukraine’s wounded have suffered such injuries, inflicted by drone attacks, shellfire and other explosions, with profound and lasting psychological implications.

“A soldier with these wounds can become afraid of himself,” Dr Dmytro Filonenko, a cranio-maxillofacial specialist, said. “He’s afraid to look into the mirror, he’s afraid his child will be afraid to hug him. One patient we had lost half of his face. When his son saw him, he started crying and ran away.

“Before I was working with cancer patients, some trauma, but few who had lost half their face,” Filonenko, 40, said. “The number now has increased dramatically. And not everything can be replaced by plastic surgery. And not all of them want long-term, multiple-steps surgery. Sometimes they want the prosthesis to pause, live some life without pain, without operation, without needles. But they want to be socialised, they want to walk the streets.”

Didur, who is married with two children, was fighting in Mariupol after Russian forces invaded. He was manning anti-aircraft batteries from the Azovmash plant next to the better-known steel plant where hundreds were besieged for weeks. As the Russians encircled them he ordered his men down to the basement. All but one went. “He was the angel who wrapped his wings around me,” Didur recalls of the moment he was wounded when a Russian tank fired on them. “In the basement he put me next to the dead because they thought I was dead too.” A military surgeon, Ivan Mikolaivich, spotted Didur was still breathing. “He said I was just a mass of flesh that could somehow still speak,” he recalled.

Didur was unconscious after emergency surgery when the Russians closed in and captured them all. When he came to, he couldn’t see. In captivity he regained sight in his right eye but not his left. It would be 15 months until Didur was selected for a prisoner swap, during which he received no medical treatment at all.

After returning to Ukraine, his shattered face was rebuilt and he chose the bright green eye to fill the empty socket. Now he volunteers at Imateh Medical every day, counselling soldiers who have suffered injuries like him to try and show them there is life beyond. “Some men get very depressed, they choose to go drinking, they can give up on life,” Didur said. “I am here to show them there is still life to be lived.”

Ruth Müller-Welt is an ocularist from Germany, the latest in a long line dating back 200 years to the great-grandfather who invented the first glass eyes. She has come to Kyiv to help in the intricate business of making and fitting prosthetic eyes and to transfer her knowledge. Kyiv has no ocularists, or at least none that the clinic can find since the war began.

“When I started 38 years ago we still saw old men who had lost their eyes in the Second World War,” she said. “But since then, until now, I have never seen this horrific kind of damage. These soldiers, they have truly terrible sockets, because they don’t just lose their eye, they lost parts of their face, bone, jaw. You wouldn’t usually see that outside of a war situation. You are not just giving them an eye, you are rebuilding an entire face.”

Hope that the eyes themselves could be 3D printed have yet to be fulfilled. “It is a very delicate, very precise art and so far it’s not good enough,” she said. “But in the coming years, it will happen.” In a brightly lit room, two soldiers, Maksym and Viktor, are awaiting the fitting of their custom-made eyes. Maksym wears a T-shirt emblazoned with the slogan “Never Give Up”.

A technician delicately paints the iris that will sit under the glass coating of the eye, holding it up periodically to Viktor’s remaining eye to make sure it matches. Noting it is too bright, he tones it down, adding tiny blood vessels to the white. Viktor was a machinegunner in the Donbas when he was wounded in April this year. He has been through many surgeries since, removing shrapnel from his face, his brain and his left eye, the one that survived. He said: “To lose one eye is not such a terrible thing because I almost lost the other too. It was a miracle they saved it. And so I am just grateful. I’ve become used to life with one eye.”