Nose Jobs in the 5th Century BCE? Plastic Surgery’s History Reaches Back Millennia
A common form of punishment during the 5th Century BCE was to lop off the nose of criminals. Men and women bearing these wounds of justice as well as those with missing or deformed noses due to war or syphilis, which causes collapse of the nostrils, had hope in India. A Hindu surgeon named Susrata (also spelled Sushruta), best known for his book on Ayurveda medicine, devised the flap method to reconstruct noses 2500 years ago.
This technique finally reached Europe around 1794, but Italy’s Gaspare Tagliacozzi had perfected his own process by then. Tagliacozzi would go on to write the first textbook on plastic surgery in the late 16th Century.
A few hundred years later, the first breast augmentation was performed in 1895, but it didn’t include implants until four years later. The original surgery used skin from the back and intended to create symmetry. Just a few years later in 1899, the first implants were comprised of injections of vegetable oil, beeswax, and paraffin.
Doctors were not trained to perform plastic surgery specifically until World War I in France. Here the surgeons learned how to perform skin grafts and reconstruct the facial features of soldiers injured in the fighting. The ravages of the world wars made the need for more functional and esthetic maxillofacial surgical techniques glaringly obvious. Thus, in 1924 John Hopkins hospital initiated a program that offered training and a fellowship. This was followed by New York Public Hospital, which added this service at the behest of Dr. Jacques Maliniac, who later went on to found the American Society of Plastic Surgeons.
Dr. Maliniac came to America during the height of anti-Semitism in Europe, and, as he was Jewish and from Poland, he elected to remain here. He learned his skills in the Russian army and was known for his dedication to the field.
He is credited with establishing the American Society of Plastic Surgeons with a mere ten members. Prior to this in 1931 the only professional association related to plastic surgery was the American Association of Oral Surgeons, and the two top plastic surgeons, Dr. Jacques Maliniac and Gustave Aufricht were not even permitted to join because they weren’t dentists.
Even with the new formation of this society, plastic surgeons were not acknowledged by board certification for a few more years. It was late in the 1930s before the American Board of Surgery established the American Board of Plastic Surgery. This led to mandated examinations to become a qualified plastic surgeon.
Since the inception of plastic surgery, the goals have not altered. The purpose was and is to improve both the function and the aesthetics of the patient.