Cosmetic Surgery History 101

As recently as 2015, The American Society for Aesthetic Plastic Surgery reported that Americans spent a total of 13.5-billion dollars on plastic surgery procedures. This number was an increase of around 1.5-billion dollars over what Americans spent the previous year. While the number of invasive and non-invasive procedures performed each year continues to grow, it’s important to remember that plastic surgery is not a new trend. In fact, cosmetic surgery procedures have been around for centuries. The tools and techniques used in plastic surgery have certainly improved over the years. However, many of the various types of plastic surgery procedures currently being performed were also used by doctors as far back as the 1800s.

Early Days of Plastic Surgery

No matter what century is studied by historians, people have always been worried about how they look and tried to do something to improve their appearance. In the early 1800s, many of the cosmetic surgery techniques that were performed involved piercings and tattooing to make a change in the outer appearance of a person. In fact, reconstructive surgeries were also born around this time as doctors invented ways to snip, stitch and inject patients.

Going even further back than the 1800s, there was a healer in ancient India known as Sushruta who is considered to be the “father of plastic surgery”. He was one of the first people to perform skin grafts by taking a piece of skin from other parts of the body and grafting it on the face to correct or enhance the look of a person with damaged skin or a disfigurement. His technique involved grafting the skin using a small bridge of tissue. The skin taken from the other part of the body would grow back thanks to natural skin cell reproduction.

By the year 600 BC, Hindu surgeons grew skilled at performing nose reconstruction. The practice of rhinoplasty was worldwide by 1000 AD. It’s often overlooked that rhinoplasty grew in popularity thanks to the custom many countries had of cutting off the noses of enemy soldiers.

A man named Gaspare Tagliacozzi, who is also considered by some to be the actual “father of plastic surgery”, started the art of nose grafting in the 16th Century. His technique involved using the skin flap of the upper arm to correct nose deformities in people. In 1798, Pierre Desault of Greece coined the word “plastikos” which translates to “molding”. The phrase “plastic surgery” later evolved from this word.

Antiseptics and anesthesia came into regular use by surgeons in the 19th Century and this led to safer ways to perform surgical procedures. As time went along, new techniques were invented to help improve the appearance of soldiers wounded during various wars over the years.

As the 20th Century continued, there were a number of firsts when it came to cosmetic surgery. 1903 saw the introduction of breast augmentation surgery in the United States. The first modern rhinoplasty in the United States was performed in 1923 while the first modern facelift viewed by the public took place in 1931.

History of Plastic Surgery in the United States

Many advances in the medical world originated in Europe but other surgical breakthroughs were accomplished in the United States. In 1827, the first cleft palate operation was performed by Dr. John Peter Mettauer using surgical equipment he personally designed. In 1907, the first text specifically centered on cosmetic surgery was written by Dr. Charles Miller. Other notable cosmetic surgeons in the United States during this era include:

Dr. Vilray P. Blair who performed the first closed ramisection of the mandible in 1909 and published a journal on surgery and diseases of the mouth and jaw in 1912

Dr.  William Luckett who extensively described a technique for correcting protruding ears in 1910

Dr. Frederick Strange Kolle who published a text on plastic and cosmetic surgery that was well ahead of its time in 1911

Origin of Modern Plastic Surgery

The modern history of plastic surgery really began in the 1960s and the 1970s. Plastic surgeons were involved in a lot of scientific developments at the time and this served as the foundation for future developments of modern plastic surgery. Silicone was initially used to treat skin conditions until Dr. Thomas Cronin developed a new breast implant device made from silicone in 1962. This was a pivotal moment in the history of modern plastic surgery. Over the next decade, silicone implants were used in almost all parts of the face and the body.

Another landmark moment in the history of modern plastic surgery was in the 1980s when many plastic surgeons and plastic surgery advocates worked on improving the public's awareness and perception of plastic surgery. The surge in the availability of credible information, combined with the economic boom of the 1980s, laid the groundwork for making plastic surgery more accessible to mainstream America. The enormous success that the world of plastic surgery enjoyed in the 1980s continued through the 1990s despite the limitations of healthcare reform. Healthcare reform greatly decreased reimbursement from insurance companies for reconstructive work. The burden was lifted in 1998 when President Bill Clinton signed a bill that allowed insurance companies to cover the cost of post-mastectomy breast reconstruction surgery.

The State of Plastic Surgery in the World Today

Plastic surgery has enjoyed an explosion in popularity over the past decade. In this era of science and technology, the Internet has played a major part in advancing plastic surgery. All plastic surgery procedures can now be viewed and/or extensively learned about from the comfort of home. The next step for plastic surgery in the world today is going towards less invasive procedures designed specifically to eradicate all visible signs of aging. As a matter of fact, the most popular procedures in the world today are cosmetic surgery treatments that make use of injectable materials such as Botox and fillers. Reports show that there are over a million Botox injections administered in the United States per year.

The demand for new techniques and procedures continues to grow as the years pass. Thankfully, there are a number of associations and medical boards that study medical procedures and oversee the medical professionals that perform plastic surgery. These organizations require their members to follow certain surgical standards and safety measures in order to actively maintain their membership. It remains to be seen what breakthroughs in plastic surgery these medical professionals will discover in the next decade or two. Their research efforts and the discovery of new techniques will more than likely make history one day in the near future.

- MA