The Renaissance: A Brief Rise in Plastic Surgery
Translations of Galen re-entered Western culture during the late Middle Ages as Crusaders encountered Arabic texts. For a brief time, plastic surgery experienced a rebirth of sorts, though mostly in barber shops. Two Sicilian barbers, a father and son team, would use skin flaps from the cheek or upper arm to rebuild a nose. The arm flap left less of a scar but demanded that the flap, still attached to the ear be joined to the nose for as long as twenty days. As in India, such surgery was a “trade secret passed on from father to son” (Gilman 1999).
After many years, certain Hindu surgeons also performed nose reconstruction by 600 BC. They used a piece of cheek skin for this reconstructive surgery. By 1000 AD, there were many surgeons around the world who performed rhinoplasty. The growing popularity of such procedure was also due to the barbaric custom adopted by many kingdoms to cut off the upper lips and noses of the enemy soldiers.
Plastic surgery would reappear in Europe in 1794 when British surgeons witnessed an Indian bricklayer repaired the nose of a British cattle driver, who had had his nose and hand cut off, while a prisoner of Tipu Sultan. British surgeons then imported the procedure to northern Europe, where interest rapidly grew. During the 16th century, Gaspare Tagliacozzi first started nose grafting with the help of the skin flaps of the upper arm. Medicine history names him as the father of plastic surgery. He used such techniques mainly to correct the saddle nose deformity in people. In 1818, Karl Ferdinand Graefe (1787-1840) coined the term “plastic surgery” and described connected grafts in his 1818 text titled Rhinoplastik. Graefe, like Tagliacozzi, believed that the world needed to see the nose-less patient in medical terms rather than as a morally branded sinner. Graefe further attempted to remove the moral stigma associated with nose reconstruction by giving the procedure a classical name (rhinoplasty) similar to other surgical procedures.
Two World Wars and Innovations in Plastic Surgery
When anesthesia and antiseptics were introduced in the 19th century, plastic and cosmetic surgeries became safer and easier. The growth of this field occurred significantly during the World Wars. War has played a significant role in the history of plastic surgery. For example, WWI trench warfare meant heads and necks were more vulnerable, and pilots and passengers in the new and dangerous airplanes often suffered serious facial injuries that were unprecedented any time in history. Injuries such as shattered jaws, blown-off noses, and gaping skull wounds accelerated the techniques and experimentation of plastic surgery and prompted Harold Delf Gilles (1882-1860) to establish the first hospital devoted to reconstructive plastic surgery (Backstein and Hinek 2005). In addition, these drastic surgeries enabled surgeons to imagine that even transgender surgery could be performed.
WW-II ushered in such plastic surgery techniques as rebuilding entire limbs, extensive skin grafts, micro surgery, antibodies, as well as increased knowledge about tissue health. Several factors contributed to the post-war plastic surgery boom and the breaking down of traditional reluctance to undergo plastic surgery. First, continued activity of professional organizations and publications helped further legitimize the industry. In addition, after there was no way to generate patients, surgeons consequently began a widespread trend toward marketing surgical techniques toward, particularly groups–particularly middle-aged, middle-class women who were affluent and largely finished with raising families.
Developments in Cosmetic Surgery
Furthermore, this demographic felt increasing pressure to remain young in a post-war culture often dubbed the “cult of the body beautiful” (Gilman 1999). Indeed, plastic surgeons would often use the vocabulary of post-war domesticities – such as sewing, housecleaning, and cooking – to refer to their procedures. Some critics even accused surgeons of inventing new names, such as “bat wing deformity” (the flabby skin on the upper arms) or “spare tire deformity” (protrusion of the lower abdomen) to create a need for plastic surgery that might not otherwise exist (ibid). By the 1960s, plastic surgery was fully integrated into the medical establishment.
New ways to Augment Breast Shape and Sizes
Gradually, cosmetic surgeons also learned new ways to augment the breast shape and size in women. Uplifting the breasts through specially designed outfits was already famous during that time. Many women then used corsets and brassieres to enhance the look of their breasts. In the 19th century, surgeons first performed the breast enlargement procedure by using artificial implants made from rubber, paraffin, ivory, and glass. Reconstructive breast surgery was first done by Czerny, in 1895. He performed the first successful mammary reconstruction on an actress who had undergone a cancerous surgery and removal of a breast tumour. Later, in 1903, Charles Miller introduced the breast augmentation surgery in the USA. He used silk floss and silk, celluloid and many other foreign materials for breast implants. However, the results were not satisfying.
Silicone breast implants also grew in popularity during the 1960s. Showgirls would inject their breasts with liquid silicon, a substance initially used in Japan in WW-I to plump out legs withered by polio. Injecting liquid silicone, however, often had dangerous side effects, such as amputation of the breasts due to infection and guaranteed “pendulous” breasts by the time women were 40. Yet advances in silicone breast augmentation (which later was made available in sac), gave hope to women who had undergone a mastectomy (Haiken 1997).
Throughout its history, plastic surgery has been shaped by cultural priorities and pressures that illuminate the complex interplay between the cosmetic and reconstructive. 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.
A select number of medical boards and associations (such as the American Academy of Cosmetic Surgery, founded in 1985) were formed and sanctioned to provide continuity of care and research along with a network of medical providers working in the field of medical plastic and cosmetic surgery. Such organizations have stringent membership requirements that require significant continuing medical education to stay abreast of recent advancements in technology, procedures, and safety. Choosing a cosmetic surgical specialist with board credentials and associations membership better assures patients that they’re receiving care from an approved and properly trained specialist.
While critics warn that plastic surgery is creating the world where beauty standards are brutally conformist, plastic surgeons today implement an exciting array of technological advances that continue to push the boundaries of their industry. For example, surgeons are researching new fillers that last longer and new lasers that inject “energy” into the skin. They are also exploring the potential of cloning technology as a method of body rejuvenation and are looking to the secrets of growth within the womb where scarless healing takes place. Without such imagination of plastic surgeons and their patients over the ages, plastic surgery would not be the phenomena it is today.
[To be continued]
Photos sourced by the author from the Net.
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