13 Things You Didn’t Know About the History of Plastic Surgery

Plastic Surgery History

When people think of plastic surgery, many imagine celebrities with perfect breasts and shapely noses. Either that or they picture reconstructive procedures on car accident or burn victims that challenge what they thought was possible from medical science.

They probably don’t realize that plastic surgery is at least as old as Ancient Egypt, predating things like anesthesia and antiseptics by several millennia. In fact, chances are there’s quite a bit you didn’t know about cosmetic surgery history. After all few, if any, high school or university history courses cover the history of plastic surgery.

Here are the facts that you should know about this ancient practice.

1. Plastic surgery is older than you think

The Edwin Smith Papyrus is the oldest known medical text that discusses trauma and surgical procedures. It was so named for the American Egyptologist who purchased the ancient text in the late 19th century.

Edwin Smith Papyrus
The Edwin Smith Papyrus

The text itself has been dated to roughly 2500 to 3000 BCE and is alleged to contain descriptions of broken noses and their repair. The reconstructive efforts of the ancient Egyptians ring true of rhinoplasty, and as such the text is generally considered to contain the earliest known mention of plastic surgery.

But the Egyptians weren’t the only culture dabbling in reconstructive surgeries. There is ample evidence suggesting such procedures were taking place in ancient Rome and India as well.

2. One of the earliest known cosmetic surgeons was a Hindu legend

The title of “father of plastic surgery” has been bestowed on both Gaspare Tagliacozzi, an Italian surgeon from the 16th century, and Harold Gillies, a 19th century surgeon from New Zealand. While they’re both celebrated for their pioneering contributions to modern plastic surgery, neither holds the title of the first plastic surgeon. An ancient Indian healer named Sushruta was actually the first plastic surgeon on record.

Sushruta doing Ayurveda medicine.

Sushruta lived in India around 600 BCE, long enough ago to earn him a mention in the epic ancient Hindu poem, the Mahabharata, where it’s said that he was the son of a legendary Hindu sage.

However, Sushruta’s true legacy is his surgical work as detailed in his Sushruta Samhita, a Sanskrit text that’s still considered foundational for modern surgery. In it he describes a wide variety of cosmetic procedures, including skin grafts and other relatively complex forms of plastic surgery.

3. The British learned about plastic surgery in India

The Sushruta Samhita text inspired a long tradition of plastic surgery practices in the country, and through its guidance many Hindu surgeons were performing rhinoplasties several hundred years BCE.

However, it’s one rhinoplasty in particular that sparked the interest of British imperialists in the country. The tale has reached apocryphal status, detailing the account of two British soldiers witnessing an Indian mason repair the nose of a British driver. Less dramatic accounts, however, acknowledge that the alleged Indian mason was in reality a trained surgeon.

Indian method of nose reconstruction, illustrated in the Gentleman's Magazine, 1794.
Indian method of nose reconstruction — Gentleman’s Magazine, 1794.

Whichever way you slice it, the tale was interesting enough to be recounted in the British Gentleman’s Magazine in 1794, thus inspiring the Brits to witness several more Indian rhinoplasties, study the Sushruta Samhita, and ultimately bring the methods back home with them to England.

4. The ancient Egyptians performed plastic surgery on the dead

We already know the Egyptians used some forms of plastic surgery on the living; the Edwin Smith Papyrus and similar ancient documents talk in some detail about treating injured soldiers with reconstructive surgery. However, the ancient Egyptians also performed modifications on their dead.

Ramses II Egyptian
Ramses II

Possibly the most famous example of this involves Ramses II, who you may remember from the story of Moses. He had a long, prominent nose. When he passed, however, his nose was unlikely to survive the mummification process. Mummification often reduced a person’s face to nothing, which presented a problem for the Egyptians who believed that one’s face appears in the afterlife as it appears in death.

To make sure that Ramses II would be recognized, they inserted small bones and seeds under his skin to give his nose structure that would survive mummification. To what extent this practice was maintained for individuals of lesser importance is unclear.

5. The ancient Romans were obsessed with plastic surgery

The ancient Romans are well known for having disdained disfigurement and other physical abnormalities. So it’s no wonder that they took to plastic surgery techniques like flies to butter. They performed everything from rhinoplasties to ear surgery. De re Medicina, a pillar text on Roman plastic surgery by Cornelius Celsus, even describes circumcision reversals that restored the foreskin (or something like it) to the penis.

Aurelius Cornelius Celsus
Aurelius Cornelius Celsus

It’s said that the Romans were undiscriminating when it came to plastic surgery. A popular theory touts that former slaves would often seek plastic surgery to remove whipping scars from their backs and, thus, the stigma of having been a slave.

Soldiers too were said to have undergone scar removal from their backs as these scars suggested the soldiers had turned their back on battle, a theory that has yet to be substantiated. What we do know for certain is that the Romans had no problem going to great lengths to honor their high standards of beauty.

6. In the Middle Ages, plastic surgery was associated with witchcraft

The Middle Ages, spanning from the 5th to the 15th century AD, witnessed a sharp decline in plastic surgery. This is largely attributed to the spread of Christianity throughout Europe and the overwhelming distrust Christians held for all forms of surgery.

Pope Innocent III
Pope Innocent III

In fact, Pope Innocent III declared that all surgeries went against Church law. He reasoned that bodily fluids could contaminate the body and soul of those who came in contact with them. Many Christians viewed plastic surgery as mystifying and believed it must somehow be related to black magic.

7. During the Renaissance, plastic surgery was practiced in barber shops

Barber surgeons handled a variety of procedures during the Renaissance. They would touch up wounds, pull teeth, amputate limbs, and, of course, cut hair. Plastic surgery was also among their list of specialties.

Barber Surgeons
17th century German barber-surgeon and his patients.

The Renaissance was, in fact, a popular period for plastic surgery, which experienced a post Middle Ages resurgence. Surgeons started experimenting with new procedures again. In some cases, they performed skin grafts using skin from other animals, such as pigs. These grafts were largely unsuccessful. Often the skin would die and shrivel up, leading the surgeons to believe that the skin was “sympathetic.” In other words, they believed that the skin died when the animal it came from died.

8. Plastic surgery came into its own during World Wars I and II

For a long time plastic surgery was considered largely experimental and treated with skepticism by many in the western medical establishment. However, World Wars I and II gave plastic surgeons an opportunity to show that their practice had practical, life-changing value.

As more and more soldiers came back from war wounded and disfigured, plastic surgeons stepped up to treat them. Nine trauma centers opened within the United States specifically to treat the facial disfigurements of war.

WWII burn victims under McIndoe's care
WWII burn victims under McIndoe’s care.

The British also saw an increase in reconstructive surgery during the war years. Sir Archibald McIndoe, a plastic surgeon from New Zealand, converted London’s iconic Queen Victoria Hospital into a specialized burn unit during the Second World War.

Plastic surgeons both developed new and refined old reconstructive techniques to manage the magnitude of cases coming to them as a result of war. The first modern rhinoplasty was performed around this time in 1923, and the first modern face-lift in 1931.

9. Early breast implants were made of some interesting materials

These days, when we consider breast augmentation, we think of silicone or saline. However, in the early years of breast implants, plastic surgeons were prone to using some remarkable and strange materials in their quest to discover what worked best.

timmie jean lindsey
Timmie Jean Lindsey, the first woman to undergo silicone breast augmentation, in 1962.

When breast augmentation procedures were first introduced to the United States in 1903, the surgeon who introduced them, Charles Miller, used silk and celluloid. Other early breast implants were made of rubber, paraffin, ivory, vegetable oil, beeswax, even glass. Yes, glass!

10. American plastic surgeons have a history of activism

The next time you drive your car, consider the shatterproof windshield before you. You have The American Society of Plastic Surgeons (ASPS) to thank for that. Alongside emergency medical personnel, in the early 20th century the ASPS petitioned to have shatterproof windshields made standard. Before these windshields came into play, severe lacerations on the face and hands from otherwise minor accidents were commonplace.

ford t
Henry Ford introduced the laminated windshield for the Model T in 1927.

Plastic surgeons didn’t only concern themselves with windshields. One doctor, George Crikelair, helped bring us the Flammable Fabrics Act of 1953, which established essential safety regulations for clothing.

Finally, plastic surgeons have long sought to make their services more accessible to the general public. They’ve gone to war with insurance companies to gain coverage for post-mastectomy breast reconstructions and reconstructive surgeries for children born with facial deformities.

11. A plastic surgeon won the Nobel Prize

Dr. Joseph Murray conducted the first live organ transplant in 1954 when he moved a healthy kidney from Ronald Herrick in to Ronald’s twin brother Richard.

Joseph Murray
Dr. Joseph Murray (left) receiving the Nobel Prize.

His research on organ transplants would lay the groundwork for numerous future procedures and save even more lives. He was recognized for his achievement in 1990 when he and his colleague, a physician named E. Donnall Thomas, shared the Nobel Prize in Physiology or Medicine.

12. The term “plastic surgery” comes from ancient Greek

Plastic surgery is a bit of a misnomer. When people think “plastic,” they think artificial. Of course, in some cases, like breast implants, there can be an artificial element. However, many plastic surgery procedures simply involve reshaping the face or body without inserting artificial materials.

French anatomist Pierre Desault
French anatomist Pierre Desault

Why is it called plastic surgery? The name, first used to describe the practice by French anatomist Pierre Desault in 1798, comes from the Greek word “plastikos,” which means “molding” or “shaping.”

13. Plastic surgeons continue to push the boundaries of medical science

The new millennium has seen some stark developments in the transplantation of body parts. In the time since Dr. Warren Breidenbach performed the first successful hand transplant in 1999, there has been a successful partial face transplant [in 2005] and a successful full face transplant [2010]. Dr. Christoph Hoehnke was even able to complete a double arm transplant in 2008 when he gave a 54-year-old man the arms of a 19-year-old.

hand transplant
Hand transplant recipient Matthew Scott with Warren C. Breidenbach, M.D.

Plastic surgeons are always looking for new, safer, and more effective ways to improve or reconstruct the human form. New techniques for reconstructing the human body and achieving elusive standards for beauty are still constantly popping up.

Where some branches of medical science might say “it can’t be done”, plastic surgeons are more inclined to ponder the ways in which a new treatment or procedure could be done.

And so far, so good.

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