Dr. Andrew Elkwood on the History of Plastic and Reconstructive Surgery, Part II: The Modern Era

October 23, 2012 § Leave a comment

During the 1600s and most of the 1700s, plastic surgery once again began to retreat into the shadows. Until the development of effective anesthesia, surgery on healthy tissues involved a great deal of pain for the patient. For this reason, modern plastic surgery involving the head or face did not become widespread until the late 19th and 20th centuries.

The origins of the modern era of plastic and reconstructive surgery date back to the late 18th century, when French surgeon Francois Chopart developed a procedure to repair lips using a flap of skin from the neck. Twenty years later, British surgeon Joseph Carpue performed a successful nose replacement procedure and German surgeon Carl Ferdinand von Graefe modified an Italian rhinoplasty technique to use free skin from the arm. Throughout the rest of the 19th century, surgeons developed techniques to repair cleft palates, improve the appearance of reconstructed noses, and utilize heterogeneous free-bone grafting to repair saddle nose defects.

The advent of new military technologies in World War I, which possessed an incredible potential to damage the appearance of the head and face, placed an increasing demand for the development of new facial and reconstructive surgery techniques. In the United States and Britain, many of the most skilled physicians and surgeons performed facial reconstructive surgery almost exclusively during the war. In the period immediately following the war, surgeons began to realize the significant impact that physical appearance could have on an individual’s success in all aspects of life. Before long, plastic and reconstructive surgery experienced a sharp rise in popularity and interest.

During the 20th century, plastic and reconstructive surgery began to gain recognition as a legitimate medical specialty. A leading force in the movement was Vilray Blair, who performed a number of maxillofacial procedures on World War I veterans and established industry standards for craniofacial reconstruction. By 1950, plastic and reconstructive surgery had become a fully integrated medical specialty.

About the author: Dr. Andrew Elkwood currently serves as a Partner at The Plastic Surgery Center and the Medical Director of the Institute for Advanced Reconstruction in Shrewsbury, New Jersey. Dr. Elkwood earned his M.D. in 1988 and subsequently completed his residency at New York University Medical Center.

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