Plastic Surgery History

The history of plastic surgery goes back to the 700s BCE. Ancient India physicians were utilizing skin grafts for reconstructive work in 8th century BC. There are notes that are describing rhinoplasty and otoplasty from those times. This knowledge of plastic surgeons existed in India up to the 18th century, which is clearly marked in the reports published in Gentleman’s Magazine. It was 1794.

Besides that the Romans were also able to perform techniques such as repairing damaged ears, from around the 1st century BC. In a book from 1465, there were descriptions and classifications of hypospadias while localization of urethral meatus was described in detail. In the same time in Europe, Heinrich von Pfolspeundt described a process: “To make a new nose for one who lacks it entirely, and the dogs have devoured it”. He clearly says that can be done by removing skin from the back of the arm and suturing it in place. But, because of the dangers of surgeries in any form, it was not until the 19th and 20th centuries that plastic surgeries became commonplace.

It took some time until the techniques of anesthesia became established, which helped a lot to start doing operations. Not only that, but infection from surgery was reduced once sterile technique and disinfectants were introduced. The plastic surgeons of the time could then use antibiotics with sulfa drugs and penicillin which made plastic surgery possible.

There is an exact procedure of how Chopart performed operative procedure of a lip using a flap from the neck in 1791. Twenty years later, there was successfully performed operative procedure on a military officer who had lost his nose. Carl Von Graefe, the German surgeon, published his major work entitled “Rhinoplastik” which was used by many doctors in the future. Another great contribution is a comprehensive text on rhinoplasty, entitled Operative Chirurgie. Concept of reoperation was introduced, which described how can cosmetic appearance of the reconstructed nose be improved.

John Roe, an American otorhinolaryngologist, presented an example of his work in 1891. His subject was a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. Year later, plastic surgeon Robert Weir experimented unsuccessfully with xenografts in the reconstruction of sunken noses. James Israel, a urological surgeon from Germany and George Monks of the United States, described the use of heterogeneous free-bone grafting to successfully reconstruct saddle nose defects. German doctor Jacques Joseph published his first account of reduction rhinoplasty. And in 1928 the same man published “Nasenplastik Und Sonstige Gesichtsplastik”.

Dr. John Peter Mettauer was the first plastic surgeon in US. Mettauer performed the first cleft palate operation with instruments that he designed himself, which was an extraordinary achievement. Another important figure in plastic surgery was Harold Gillies who developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in first World War. The work he started there was expanded during World War II by his cousin Archibald McIndoe. He pioneered treatments for RAF aircrew suffering from severe burns. His radical treatments lead to the formation of the Guinea Pig Club.

Plastic surgery evolved greatly during the 20th Century in the US. Vilray Blair was one of the founders who served as the first chief of the Division of Plastic and Reconstructive Surgery within Washington University in St. Louis. He had many areas of expertise, one of them being treating soldiers with complex maxillofacial injuries. Dr. Blair wrote a paper on “Reconstructive Surgery of the Face” that had set the standards for craniofacial reconstruction. Besides that, he was one of the first non-oral surgeons elected to the American Association of Oral and Plastic Surgery. He taught many plastic surgeons who became leaders in the field of plastic surgery.

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