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The History of Plastic Surgery

Plastic surgery has been performed since antiquity with the earliest origins of primitive plastic surgery dating back to Ancient Egypt. The nose received the most attention from early plastic surgeons¹. The term plastic surgery stems from the Greek word plastikos meaning moulding and shaping.

The First World War triggered significant developments in plastic surgery with the reconstruction of servicemen’s wounds. From that time onwards the discipline advanced using less invasive procedures and widened so that all areas of the body could be reformed. Plastic surgery is now used to reconstruct defects in the body or to aesthetically enhance its normal form. It has risen greatly in popularity in recent years with new techniques and it becoming more affordable to the wider market. In 2015, over 21 million surgical and non-surgical cosmetic procedures were performed globally².

Here we take a look at some key dates throughout the history of plastic surgery.

Ancient times

1600 BC

Plastic surgery is mentioned in papyrus from Ancient Egypt when it was first primitively used to repair a broken nose.

1213 BC

In Egypt plastic surgery was used on corpses for the afterlife. Mourners of an Ancient Egyptian King, called Ramses II who had a large and long nose, surgically inserted bone and seeds into his nose to make sure he was recognised and received as a king in the afterlife.

600 BC

Sushruta an Indian physician is known for his pioneering operations and techniques including the repairing and remaking of a nose.

Sushruta Samhita is his famous surgical compendium in which Sushruta describes the basic principles of plastic surgery.

100 BC to 5th Century AD

The Romans performed simple plastic surgery techniques to improve their image such as repairing damaged ears. Medical writer Aulus Cornelius Celsus described plastic surgery of the face, using skin from other parts of the body³. His book was the plastic surgeons guide for more than 1700 years.

15th century AD

Sushruta Samhita was translated into Arabic and plastic surgery spread through Europe.

Italian surgeons Gustavo Branca and his son Antonio Branca developed the rhinoplasty techniques and took skin from the forearm instead of the forehead and cheeks to create less scaring. However, this required the forearm to be attached to the nose for ten days!

1800’s

Plastic was first used to describe cosmetic surgery by German surgeon Karl Ferdinand von Graefe when he published his major work entitled Rhinoplastik, a modification of the Italian method.

The skin graft was rediscovered in the Sushruta Samhita and Felix Jean Casimir Guyon of Paris and Jacques Reverdin of Geneva started to develop more advanced skin grafts in their practice in 1869 that are similar to what we use today.

In 1895 the first documented breast augmentation surgery was performed by transplanting tissue from the back to the breast to correct asymmetry4

20th century

1914-1918

British plastic surgery was born during the First World War. Bullets and explosive shells caused terrible head and facial injuries amongst soldiers in conflict. Major Harold Gillies, serving in the Royal Army Medical Corps, established a centre devoted to facial repair at the Queen Mary's Hospital in Sidcup, Kent. Here Gillies attempted ground-breaking procedures, which paved the way for modern plastic surgery. He is widely considered to be the ‘father of plastic surgery'.

After the first world war Gillies set up private practice. He was appointed a consultant in plastic surgery to many esteemed establishments.

1930s-1940s

There were four plastic surgeons practising in England: Gillies, McIndoe, Kilner and Mowlem, who became known as ‘The Great Four'.

Archibald McIndoe learned how to surgically rebuild the faces of airmen burned in war who were known as the Guinea Pig Club.

World War Two brought many new plastic surgery techniques such as rebuilding entire limbs, extensive skin grafts for burns victims and microsurgery, as well as an increased knowledge about tissue health and antibodies. 

1942

In 1942, following the Battle of Britain, Gillies and McIndoe operated on burnt airmen with the media in attendance, pushing plastic surgery into the public eye.

1946

The founding of the British Association of Plastic Surgeons. Sixty years later, its name was changed to the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) to reflect the work performed by modern-day plastic surgeons and to encompass all specialties and skills within plastic surgery.

Post war, plastic surgery became more accepted as traditional reluctance to undergo plastic surgery was broken down. There were now professional organisations that helped legitimise the industry and an increase in interest particularly from middle-aged, middle-class women.

Modern day

Plastic surgery has made tremendous strides during the last half of 20th century and up to present day. It has gained public acceptance as a method of achieving the desired look for both women and men. It has become more affordable and changed the appearance and lives of many people.

Plastic surgeons have developed innovative techniques to reduce the effects of aging on the face and body or to reshape noses, breasts and other body parts.

In the 1960s and 1970s a newly created substance called silicone grew in popularity. In 1962, Dr Thomas Cronin introduced silicone breast implants.

The 1980s and 1990s saw an increase in plastic surgery as: public perception improved, there was a shift towards more quality procedural information being made available and, the economic boom continued. 

Non-surgical procedures including injectable fillers and laser treatments were developed and introduced as an option for people who want cosmetic enhancement without undergoing surgery. There are now a wide number of non-surgical options that have grown in popularity worldwide.

The field of plastic surgery continues to develop with new technologies and advancements.

References

¹ https://www.royalfree.nhs.uk/services/services-a-z/plastic-surgery/facial-reconstruction-and-face-transplants/history-of-plastic-surgery/

² https://www.isaps.org/Media/Default/global-statistics/Global%20Survey%20Press%20Release_V2.pdf

³ https://www.britannica.com/biography/Aulus-Cornelius-Celsus

https://www.plasticsurgery.org/about-asps/history-of-plastic-surgery

http://www.bapras.org.uk/public/history