Today’s case was harder than I imagined and will need more work. Luckily the funeral isn’t for another week so I will have plenty of time. I will document, as much as I can without breaching ethics, the steps I took.
I was presented with a middle-aged slightly obese autopsied female, partially frozen. On the viewing side of her face she had a deep laceration, basically splitting the face diagonally and removing part of her lip. No bone was visible and there were no broken bones in the face. She had her own teeth and a natural mouth closure.
Before the embalming, I packed the facial cut with cauterizing chemicals. I embalmed the body as usual for an autopsied case, treated the viscera, and sutured the body together. There was no damage to the skull or the left facial bones so I was able to replace the cranium and suture the scalp as usual.
I removed the cauterant pack from the wound, dried it as much as I could, and packed it with sealing powder. I then sutured it closed using a thinner ligature and a hidden stitch wherein I passed the needle only through the underlying facial muscles and not the skin. When this was finished, the mark of the wound could be seen, but not the sutures. I applied more cauterizing gel and let this sit overnight.
Today I removed the chemicals and saw the inside of the wound was still slightly moist and would need more work, but there was no time before the viewing. I applied a thin layer of liquid plastic over the wound and when this dried, covered it with mortuary wax. I used several layers of a medium-consistency wax that is designed for filling bullet holes.
I used wax in a thicker consistency to recreate the missing part of her lip, then covered the whole face with an opaque cosmetic in her skin tone. I used a lip brush to draw an outline of where her lips would have been, then used a stippling brush to create a natural looking skin texture with pores. I also injected a filler into her lips to even them out, and into several places on her wrists where, due to her size, I had to tie her hands together overnight as the chemicals set up. The straps left indentations.
I presented this body for viewing under pink lights and with only the face and head visible. The family was in agreement that this was passable, but that more work was necessary. However, I did sit them down beforehand to tell them what to expect. They had not been aware of the extensive wound, and perhaps would not have noticed had they not been looking for it. I still stand by my decision to explain to the family everything I know about the body, in every case.
Tomorrow I will remove all cosmetics and focus on drying out the wound as much as possible. I also asked the family for her own makeup so I can create a look they are used to seeing.
So far I am pleased with the result and it had me wishing I could take before-and-after pics and submit them to textbooks.