Today, here, and around the world, many people have considered having Cosmetic Surgery, or Plastic Surgery performed. Many more have had plastic surgery done, some with multiple procedures. Plastic Surgery, by definition, is a broad term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. Medical treatment for Facial injuries dates back over 4,000 years. The word “plastic” is a derivative of the Greek word plastikos meaning to mould or shape; however, contrary to common belief, the term “plastic surgery” is not related to modern plastics at all.

Cosmetic Surgery was first known to have been performed in Roman times. The Romans had the ability to perform simple procedures such as repairing damaged ears, in modern times referred to as Otoplasty, this is one of the most simple of procedures. One report discusses a patient getting his earlobes repaired after years of wearing heavy earrings. The excess lobes were trimmed and the hole sewn together. One of the more expensive plastic surgeries performed at the time, the removal of branding and scars, was a commonly executed procedure. Freed slaves paid a high price indeed for this type of surgery. It was felt that this common practice reduced the stigma of having been a slave in this ancient times.

In ancient India physicians were able to use skin graft reconstruction techniques as early as 800 B.C. From ancient times to the early nineteenth century, we find a living tradition of plastic operations of the nose, ear and lip. The Kangra (correctly pronounced as ‘Kangada’) district in Himachal Pradesh was most famous for its plastic surgeons. Some scholars are of the opinion that the word ‘Kangada’ is made from ‘Kana + gadha’ (ear repair). The British archaeologist Sir Alexander Cunningham (1814-93) had written about the tradition of Kangra plastic surgery procedures. We also have information that in the reign of Akber ,a Vaidya named Bidha used to carry out plastic operations in Kangra.

The Charaka-Sanhita and the Sushruta-Sanhita are among the oldest known manuscripts on Ayurveda (the Indian science of medicine). Chronologically speaking, the Charaka-Sanhita is believed to be the earliest work, and deals with medicine proper and containing a few passages on surgery. The Sushruta-Sanhita, a work of the early centuries of the Christian era, mainly deals with surgical knowledge rather than medicine. The extant Sushruta-Sanhita is, according to its commentator Dalhanacharya (of twelfth century AD), a amendment by Nagarjuna. The original Sushruta-Sanhita was based on a series of lectures between Kashiraj Divodas (or Dhanvantari) and his disciples, Sushruta and others.

In 15th Century Europe, a man by the name of Heinrich von Pfolspeundt , a German physician and a member of the Teutonic Order of Knights was one of the first known Europeans to have performed cosmetic surgery. Dr. Pfolspeundt was one of the first doctors of the late medieval and early Renaissance period to take medical practices beyond the very crude conditions that had existed through much of the Middle Ages. During his time, a good number of German physicians, especially those in Strasbourg, helped to serve the advancement of the study of medicine. Dr. Pfolspeundt described a procedure to make a new nose for a person who lacks one. He stated that by removing skin from the back of the arm and suturing it into place a new nose could be created.

From Italy we have records that would indicate that in the year 1442, Branca, a surgeon of Catania in Sicily, carried out plastic surgery of the nose, Also known as rhinoplasty, using a skin flap from the face. This procedure was very similar to the one described in the Sushruta-Sanhita, an Ayurvedic compendium composed in the early centuries of the Christian era. His son Antonio continued his work and was the first known to use a skin flap from the arm for reconstructing the nose. The Boinias family carried on with his work. The plastic operations carried out by the Boinia brothers are described in a book published in 1568 by Fioravanti, a doctor of Bologna, Italy.

At the hands of Gasparo Tagliacozzi (1546-99), a professor of surgery and of anatomy at the Bologna University, that plastic surgery attained wide fame in Europe. His book De curtorum chirurgia per insitionem (The surgery of defects by implantation), printed in 1597, was the first scientific composition on plastic surgery. Tagliacozzi had described a method of substitution of the nose by skin from the arm and of replacement of the ears and lips, demonstrating his work throughout his manuscript by way of a large number of illustrations.

The Church dignitaries of the time regarded cosmetic surgery as an interference in the affairs of the Almighty. After his death they not only excommunicated Tagliacozzi, but also had his corpse exhumed from its church grave, and placed it in unconsecrated ground. The great Voltaire (1694-1778) wrote a satirical poem on Tagliacozzi and his operation on the nose, using flap from the buttocks.

However, due to the many dangers of surgery in those times, cosmetic surgery was rarely performed until around the 1900’s. The United States first plastic surgeon was Dr. John Peter Mettauer, born in Virginia in 1787, who in 1827 performed the first cleft palate surgery on record with instruments he himself designed.

There are two very broad fields of aesthetic surgery, Cosmetic Surgery and Reconstructive Surgery. Reconstructive surgery, including microsurgery, focuses on undoing or masking the destructive effects of trauma, previous surgery or disease. Examples of such operations are the rebuilding of amputated or damaged arms or legs; repairing cleft palates or lips, badly formed noses, and ears; and reconstructing a breast after mastectomy. Reconstructive surgery may include moving tissue from other parts of the body to the affected area.

Cosmetic surgery however, is an elective surgery, usually done more for aesthetic reasons rather than to repair an injured area. In many cases, however, there are medical reasons for having some procedures done, such as breast reduction (for back pain relief) and Mastopexy (also known as a “breast lift). Cosmetic Surgery includes, but is not limited to, Abdominoplasty, or “tummy tuck”, Blepharoplasty, or “eyelid surgery”, Augmentation Mammaplasty, or “breast enlargement”, and Rhytidectomy, or “face lift”.

There are many more procedures not listed here that are commonly performed as well. The top five surgical procedures in 2004 Liposuction (325,000), nose reshaping (305,000), breast augmentation (264,000), eyelid surgery (233,000), and facelift (114,000).

As you can see, Plastic Surgery has a longstanding history across the ages. It has helped not only in the reconstructive plastic surgery field but also has allowed people to feel more comfortable with their bodies and more confident about themselves.

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