Plastic surgery - past, present and future

Posted: 21/11/2014

Plastic surgery, derived from the Greek term ‘plastikos’, meaning ‘to mold’, dates back to antiquity and denotes different things to different cultures. The history of plastic surgery is fascinating and in this short article, Alison Johnson, senior associate in the cosmetic surgery team at Penningtons Manches, outlines the very early days of the specialty.

Being the practice of reshaping body tissue for reconstructive or cosmetic purposes, early examples of plastic surgery were the tribal traditions of disking lips, stretching earlobes, binding feet, filing teeth and tattooing skin. The Egyptians would prepare their dead for burial using principles of plastic surgery. Mummies might have had prominent features, typically facial features, preserved by surgical means to ensure recognition in the afterlife. Interestingly, there is little evidence of the Egyptians performing plastic surgery on the living.

Ancient India is widely accepted to have been the birthplace of plastic surgery and where the first recorded accounts of reconstructive surgery appear. Historical scripts describe procedures to repair noses and ears, either lost in battle or cut off in punishment for criminal activity, commonly adultery.

The Romans were also practising advanced plastic surgery procedures, perhaps prompted by the very public Roman baths. In a culture that praised the beauty of the naked body in both art and poetry, Romans viewed any abnormality, particularly the genitalia, with suspicion or even amusement. Consequently one of the most popular plastic surgery procedures appeared to be circumcision removal.

Roman surgeons would also remove scars, particularly those on the back, which were deemed marks of shame because they suggested that a man had turned his back in battle or, worse, he had been whipped like a slave. Surgeons would often operate on gladiators who had noses and ears chopped off and on foreigners who would try to fit into Roman society.

World War Two was a turning point for plastic surgery in that surgical techniques such as rebuilding entire limbs, extensive skin grafts for burns victims and a significant amount of microsurgery became commonplace. That in turn prompted a shift in attitude and a breaking down of traditional reluctance to undergo plastic surgery in the post-war times.

Throughout its history, plastic surgery has been shaped by cultural priorities and pressures and the fact that many Western societies today have become more comfortable with plastic surgery suggests that they view it as another method of self-improvement, not just for women, but men as well. We have seen first-hand the amazing work that is done in the reconstructive field in particular and as an example, reconstructive breast surgery after cancer has transformed the lives of many women. We hope that advances in plastics can continue to be put to such good use.

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