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Plastic Surgery Print E-mail

Dr. Kennedy

The use of the word "plastic" with "surgery" derives from the Greek plastikos meaning to mold or shape. In this context it has nothing do with the synthetic polymer material known as plastic. Plastic surgeons typically mold and reshape bone, cartilage, muscle, fat, and skin. Plastic surgery uses surgical and nonsurgical techniques to change the appearance and function of a person's body. Plastic surgery procedures include both cosmetic enhancements as well as reconstructive operations to improve function. In plastic surgery, where aesthetics are of primal importance, plastic surgery is referred to as cosmetic surgery.

The history of plastic surgery reaches back perhaps as much as 4,000 year, but becomes reasonably well documented around 700 BC. Physicians in ancient India, including one Sushruta Samhita, were utilizing skin grafts for reconstructive work as early as the 8th century BC. Sushruta Samhita describes rhinoplasty and otoplasty. This knowledge of plastic surgery existed in India up to the late 18th century. The Romans were repairing damaged ears from around the first century BC. In mid-15th century 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 described removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form due to infection (no one knew about germs and sanitation in that era), especially that involving the head or face, it was in the 19th and 20th centuries that such surgery became commonplace. And, until anesthesia became established, all surgery on healthy tissues involved great pain as well as infection. Infection from surgery was reduced dramatically once sterile technique and disinfectants were introduced. The invention and use of antibiotics was a huge step in making elective surgery possible.

To do justice to recent advances in plastic and cosmetic surgery would require a large book, however, here are a few of the early highlights of cosmetic plastic surgery:

  • 1791 Chopart performed operative procedure of a lip using a flap from the neck.
  • 1814 Joseph Carpue performed operative procedure in a British military officer who had lost his nose to the toxic effects of mercury treatments.
  • 1818 Carl Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap.
  • 1827 John Peter Mettauer, the U.S.'s first plastic surgeon, performed the first cleft palate operation with instruments that he designed himself.
  • 1845 Dieffenbach wrote a comprehensive text on rhinoplasty, entitled "Operative Chirurgie" introducing the concept of reoperation to improve the cosmetic appearance of the reconstructed nose.
  • 1891 John Roe, an American otorhinolaryngologist presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic indications.
  • 1892 Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses.
  • 1896 James Israel, a urological surgeon from Germany, and In 1889 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects.
  • 1898 Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty .
  • 1928 Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik.

The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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