ONE WORD: PLASTIC

Many people ask me why my chosen surgical field was named after a manufactured material, and I have to explain that plastic surgery is not in fact named for plastics.  Rather, the origin of both names is from the Greek word “plastikos,” which means to mold or to shape. Just as the new material could be molded into the shape of a cup, spoon or plate, so, too,  human tissue could be molded into new shapes or forms.  Although both the science of manufacturing plastic materials and the field of plastic surgery were named in the 20th century, the origins of plastic surgery stretch back much further into antiquity.

Though they didn’t have the multitude of  theatrical productions about plastic surgery back then, the history of  plastic surgery is ancient, going back as far as 2000 B.C. in India and Egypt.  Egyptian hieroglyphics depict the earliest known plastic surgery procedures, in which reeds were used in nasal surgery to keep the airways open as the nose healed around themIn India, the physician Acharya Shushrut published a major plastic surgery text, the “Sushruta Samhita,” a compilation of surgical procedures. The Romans delved into plastic surgery as well, with descriptions of breast, eyelid, and facial surgeries surviving to today.  In “De Medicina,” author Aulus Cornelius Celsus described surgical techniques related to facial and breast surgery.   Afterwards, the development of plastic surgery was stalled through the Middle Ages until its re-emergence in a spectacular fashion in the works of Gasparo Tagliacozzi of Sicily.

In the 1500s, Tagliocozzi began the modern era of flap reconstruction of the nose. Beautiful drawings survive describing his attempts to reconstruct the surface of the nose by attaching the skin of the arm.  The patient would continue in this somewhat awkward position until a new blood supply repopulated the tissue of the arm, and the arm could be detached and resume its normal functions.  I’ll never forget seeing the original text of “De Curtorium Chirugiau” in the Webster Library at Columbia University’s College of Physicians and Surgeons with its large drawings depicting this operation.

Surgeries continued over the next few centuries. But the modern era of plastic surgery began as an outgrowth of the horrors of the First World War.  With trench warfare and modern weaponry, hundreds of thousands of soldiers were left with traumatic injuries to the face, extremities and torsos.  Dr. Sir Harold Delf Gillies – known as the father of plastic surgery – established The Queen’s Hospital, the first one devoted to reconstructive work, in Sidcup, England in 1917 following the Battle of the Somme. More than 5,000 facial plastic surgeries were performed there.

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