The short story of plastic surgery

1000 b.C.-IV sec. a.d

Handsome at all costs!Since ancient times.

We can find tracks of plastic surgery already in the egiptians writing and sanscriti writing where there are descriptions of surgery for a facial trauma and fractures of the jaw and nose.

For the first reconstruction of noses, ears and lips we must get to Hindu texts dating to about 400 a. C. At the time fashion was cutting the nose to the enemy, and even the judiciary imposed the amputation of noses, ears and genitals. No wonder then that an Hindus author, Sushrata, described for the first encyclopedia in its Samhita, the ear reconstruction with skin taken from the cheek and nose reconstruction with the even today called “Indian method” or “Hindu”.

And always to Hindù doctors we have to refer for the first transplantation of skin taken from the buttocks.

476 d.C-1816 d.C

The short story of plastic surgery (476 d.C-1816 d.C)The fall of Rome in the 5th century and the barbarian invasions made these techniques disappear. And the Middle Ages was a period of backwardness. With a few exceptions: in the 920 in  the Leechbook of Bald, the English text of ancient medical practices, there was the description of the first operation to correct cleft palate: a malformation of the palate that during pregnancy is not firm.
But in the 13th century Pope Innocent III forbade surgery, and most of the doctors of th time began to consider dishonorable and vulgar the manuality of surgery which turned responsibility of the barbers. The plastic surgery was then reintroduced in Europe in the 9th -12th century by Arabs whom learned those in the Indo valley and brought those in the Mediterranean once again after Spain and Sicily had been conquested.

Cerrahiye-i Ilhaniye, the first illustrated text of surgery is assets of turkish-Islamic literature: Serafeddin Sabuncuoglu described there the techniques of maxillo-facial surgery, diseases of the eyelids and gynecomastia: still today his technique to remove the glandular tissue anticipates modern reductive mammoplastic.

At the Boulogne University, Italy, Leonardo Fioravanti disclosed the technique of transplantation. This goes back to Hindu civilization, around 2500 years ago, but it was reintroduced in Europe by the Arabs. The first description of Fioravanti, dates back to 1570 when “a Spanish gentleman called Andreas Gutiero, which had been cut off the nose in a duel, it had been dropped it in the sand and that I had in my hand, was full of sand: I urinate on it and I washed with it, I sticked it leaving it there 8-10 days. “. rough but effective.

A scyentific middle age illustration mixed with astrology

The short story of plastic surgery (476 d.C-1816 d.C)But in the 16th Century another dark period started for surgery, which than saw the light again thanks to the English just in the 18th century after India was conquested.

Lucas, a British surgeon, described the reconstruction of the nose by an Indian Koomas. Shortly before, was the 1791, Chopard reconstructed a lip using a flap of skin turned from the neck.
Among the readers of the full story of Joseph Lucas was Carpue, a York Hospital surgeon in Chelsea in England: he drilled on corpses and in 1814 accomplished the first step on a British official who had lost his nose for a poorly made aterapia basis on mercury, and on another journalist maimed by a saber. Carpue published his work under the title “Restoration of a Lost Nose” in 1816 giving new splendor to the Indian Rhinoplastic.


The birth of modern plastic surgery….

Breast operation in 1831, without anaesthetic and with low igenic precaution to avoid infections
Breast operation in 1831, without anaesthetic and with low igenic precaution to avoid infections

Two years later, the 1818 was running, the German surgeon Carl Von Graefe, considered the best surgeon in Europe and the father of modern plastic surgery, published “Rhinoplastik”: he there mentioned 55 rhynoplastic operations, but also measures to operate Blepharoplasty (eyelid plastic) and palatoplastica, so as to be considered the father of modern plastic surgery.

But only his successor made the techniques more tolerable thanks to the introduction of anesthesia and the nose operation in two steps to improve its appearance.
For the complete reconstruction of the nose the bone issue was a real problem: the answer goes back to 1892 when Robert Weir used the duck sternum, and coined for the first time the word “rhynomania”, the research of pathological perfection by the patients. “There is no doubt that this behavior persists today and iit s still one of the most important problems of aesthetic plastic surgery ‘.

But the first aesthetic operation is dated to the end of the 19th century thanks to John Orlando Roe, who made the first rhynoplastic operation.


….and the aesthetic one: the important is the beauty

Until the end of the century 19mo plastic surgery was almost exclusively reconstructive and of little value. Then the first world war changed all, thanks to military plastic surgery which was used to correct many trauma to the head reported in battle permitted to improve the discipline, particularly with regard to maxillofacial surgery. In plastic surgery military centers injuries of heads and necks were repaired and if before the first great war masks were used to cover the most terrible wounds after that, disfigured faces would have been repaired by surgeons.
Between 1920 and 1940 plastic surgery was also accepted in the university.

Improvements of anesthesia, use of transfusions, sulphonamides and penicillin permitted to control infections, reduce the rate of mortality and brought more morbidity to the procedures during the war. In some centers the plastic surgical mortality was zero. In addition, amputation in the Second World War was used less than in previous conflicts. In this period we learned to use the lieaco bone for facial bones reconstruction.

And the breast grows.
At the end of the 19th century surgery began to increase breasts with injections of synthetic material. In 1899 they tried with paraffin, then with beeswax, vegetable oils and other crap, until starting from 1960 when this practice was prohibited for damages caused to patients. It then went to implantable protheses: the first were ivory or glass, but those were abandoned because the breas did not seem natural. Then it was the turn of sponge mats, as the Ivalon, which could be modeled to give a more natural appearance to breast, but  by the time they got distorted or mor hard. The modern facilities, silicone-based, began in 1963.

Liposuction is the most recent: the technique of sucking fat with a cannula was invented from Ithe talian Arpad Fisher, and developed in 1987 by dermatologist Jeffrey Klein with a new technique which allowed the removal of a greater volume of fat, but with less loss of blood.

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