Today getting a nose job or tummy tuck look like a common procedure. Made famous by celebrities and common by the masses that followed suit, getting cosmetic surgeries have become indispensable in the quest to retain one’s youth. Most of us believe that cosmetic surgeries are a byproduct of advancement in science and medicine in the modern age and people from centuries ago were simply stuck with herbs and potions when it came to their beauty regimen. But that is not the case. Plastic surgeries have an ancient history, which we will explore in this article. We will see how it progressed through time and came into its modern form which we know today.
The beginnings of plastic surgery are closely related to the beginnings of medicine itself. As early as 1200 BC A high number of nasal operations is documented in India during which a “vascular flap” was cut from the forehead and formed into a new nose. Most of the time there were very specific reasons for the intervention: According to Indian law, criminals, adulterers and prisoners of war had their noses amputated as a punishment. Reconstructive interventions were also known in ancient Egypt, as demonstrated by mummy finds with sewn-on ears. The Roman medical writer Aulus Cornelius Celsus (25 BC – 50 AD) also describes numerous interventions in his works, such as covering defects in the face with the help of skin flaps.
Around 1450, the Sicilian surgeon Branca discovered the “Indian method” for nose reconstruction and performed it in numerous operations. His son Antonio developed a new method, the stalked arm flap (spacer flap). Instead of removing tissue from the forehead, with this “Italian method” a new nose was formed from the tissue of the upper arm. Unlike in ancient India, nasal plastic surgery was mainly performed in the 15th century because of duel or war-related mutilation, but also when the nose was syphilitic.
Antonio Branca kept his new method top secret. It was not until 1597 that the Italian surgeon Gasparo Tagliacozzi described the arm rag along with other operations in his book “De Curtorum Chirurgia per Insitionem”. The publication is considered to be the cornerstone of modern plastic surgery and soon aroused the interest of the Church. In their opinion, mutilations were willed by God and should therefore not be corrected by humans. For Tagliacozzi a hopeless fight against an overpowering opponent began. Even after his death, the princes of the church condemned his soul, exhumed his body and buried it outside the cemetery.
Berlin, birthplace of modern plastic surgery
It was not until 220 years later that the Berlin Charité professor Karl Ferdinand Graefe carried out several nose reconstructions using Tagliacozzi’s method and summarized his findings in the book “Rhinoplastik” (1818). In 1823 the French surgeon Jacques Delpech described a nose and lip reconstruction using the “Italian method”. In 1838 Eduard Zeis first mentioned the term “plastic surgery” in his extensive work “Manual of plastic surgery”. The foreword was written by the Graefe student Johann Friedrich Dieffenbach, who a few years later was to write an influential standard work. “The operative surgery” (1845) was the name of the monumental work in which Dieffenbach precisely described numerous operations and for the first time defined plastic surgery as an independent field. Reconstruction of noses.
The late 19th century brought a flood of new knowledge, especially in the field of skin grafts. In 1895 the surgeon Vincenz Czerny performed the first breast augmentation on a tumor patient. The devastating injuries caused by the First World War required a further acceleration in plastic-surgical research. Above all, the experience reports by the British Harold Gillies and the German Erich Lexer (“Die Gesamtreformschirurgie”, 1931) quickly became standard works of reconstructive surgery. Lexer, who later supported the National Socialists with the “Law for the Prevention of Hereditary Diseases”, had already carried out the first facelift in Germany in 1906, followed by the first documented breast reduction in 1920/21.
After the wars
After the Second World War, which again presented reconstructive surgery with new challenges, the spread of microsurgery in particular provided previously undreamt-of possibilities. In 1944, the American Sterling Bunnell founded modern hand surgery, which benefited greatly from modern microscopes from the 1960s onwards. The introduction of silicone implants in 1962 by Thomas Cronin and Frank Gerow (USA) or the first transplantation of a toe as a thumb replacement in 1968 by John Cobbett (UK) were further decisive milestones in plastic surgery. The first facial transplantation performed on a living person in 2005, impressively shows the possibilities and advances in plastic surgery.