Plastic surgery From Wikipedia, the free encyclopedia Plastic surgery is a medical procedure with the purpose of alteration or restoring the form of the body. Though cosmetic or aesthetic surgery is the most well known kind of plastic surgery, plastic surgery itself is not necessarily considered cosmetic and includes many types of reconstructive surgery, craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. Etymology In the term plastic surgery, the adjective plastic implies sculpting or reshaping, which is derived from the Greek πλαστική (τέχνη), plastikē (tekhnē), “the art of modelling” of malleable flesh.[1] This meaning in English is attested as early as 1598.[2] The surgical definition of "plastic" first appeared in 1839, preceding the modern "engineering material made from petroleum" sense of plastic (coined by Leo Baekeland in 1909) by seventy years.[3] History See also: History of surgery Treatments for the plastic repair of a broken nose are first mentioned in the Edwin Smith Papyrus,[5] a transcription of an Ancient Egyptian medical text, some of the oldest known surgical treatise, dated to the Old Kingdom from 3000 to 2500 BC.[6] Reconstructive surgery techniques were being carried out in India by 800 BC.[7][8] Sushruta was a physician that made important contributions to the field of plastic and cataract surgery in 6th century BC.[9] The medical works of both Sushruta and Charak originally in Sanskrit were translated into the Arabic language during the Abbasid Caliphate in 750 AD.[10] The Arabic translations made their way into Europe via intermediaries.[10] In Italy the Branca family[11] of Sicily and Gaspare Tagliacozzi (Bologna) became familiar with the techniques of Sushruta.[10] British physicians traveled to India to see rhinoplasties being performed by native methods.[12] Reports on Indian rhinoplasty performed by a Kumhar vaidya were published in the Gentleman's Magazine by 1794.[12] Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods.[12] Carpue was able to perform the first major surgery in the Western world by 1815.[13] Instruments described in the Sushruta Samhita were further modified in the Western world.[13] The Romans also performed plastic cosmetic surgery. The Romans were able to perform simple techniques, such as repairing damaged ears, from around the 1st century BC. For religious reasons, they did not dissect either human beings or animals, thus their knowledge was based in its entirety on the texts of their Greek predecessors. Notwithstanding, Aulus Cornelius Celsus left some surprisingly accurate anatomical descriptions,[14] some of which — for instance, his studies on the genitalia and the skeleton — are of special interest to plastic surgery.[15] In 1465, Sabuncu's book, description, and classification of hypospadias was more informative and up to date. Localization of urethral meatus[disambiguation needed] was described in detail. Sabuncuoglu also detailed the description and classification of ambiguous genitalia.[citation needed] In mid-15th-century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgery became common. Up until the techniques of anesthesia became established, surgeries involving healthy tissues involved great pain. Infection from surgery was reduced by the introduction of sterile techniques and disinfectants. The invention and use of antibiotics, beginning with sulfonamide and penicillin, was another step in making elective surgery possible. In 1793, François Chopart performed operative procedure on a lip using a flap from the neck. In 1814, Joseph Carpue successfully performed operative procedure on a British military officer who had lost his nose to the toxic effects of mercury treatments. In 1818, German surgeon Carl Ferdinand von Graefe published his major work entitled Rhinoplastik. Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap. The first American plastic surgeon was John Peter Mettauer, who, in 1827, performed the first cleft palate operation with instruments that he designed himself. In 1845, Johann Friedrich Dieffenbach wrote a comprehensive text on rhinoplasty, entitled Operative Chirurgie, and introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. In 1891, American otorhinolaryngologist John Roe presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896, James Israel, a urological surgeon from Germany, and in 1889 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects. In 1898, Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty. In 1928, Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik. Development of modern techniques The father of modern plastic surgery is generally considered to have been Sir Harold Gillies. A New Zealand otolaryngologist working in London, he developed many of the techniques of modern facial surgery in caring for soldiers suffering from disfiguring facial injuries during the First World War. During World War I he worked as a medical minder with the Royal Army Medical Corps. After working with the renowned French oral and maxillofacial surgeon Hippolyte Morestin on skin graft, he persuaded the army's chief surgeon, Arbuthnot-Lane, to establish a facial injury ward at the Cambridge Military Hospital, Aldershot, later upgraded to a new hospital for facial repairs at Sidcup in 1917. There Gillies and his colleagues developed many techniques of plastic surgery; more than 11,000 operations were performed on over 5,000 men (mostly soldiers with facial injuries, usually from gunshot wounds). After the war, Gillies developed a private practice with Rainsford Mowlem, including many famous patients, and travelled extensively to promote his advanced techniques worldwide. In 1930, Gillies' cousin, Archibald McIndoe, joined the practice and became committed to plastic surgery. When World War II broke out, plastic surgery provision was largely divided between the different services of the armed forces and Gillies and his team was split up. Gillies himself, was sent to Rooksdown House near Basingstoke, which became the principal army plastic surgery unit; Tommy Kilner (who had worked with Gillies during the First World War, and who now has a surgical instrument named after him, the kilner cheek retractor), went to Queen Mary's Hospital, Roehampton, and Mowlem to St Albans. McIndoe, consultant to the RAF, moved to the recently rebuilt Queen Victoria Hospital in East Grinstead, Sussex, and founded a Centre for Plastic and Jaw Surgery. There, he treated very deep burns, and serious facial disfigurement like loss of eyelids, typical of those caused to aircrew by burning fuel. McIndoe is often recognized for not only developing new techniques for treating badly burned faces and hands but also for recognising the importance of the rehabilitation of the casualties and particularly of social reintegration back into normal life. He disposed of the "convalescent uniforms" and let the patients use their service uniforms instead. With the help of two friends, Neville and Elaine Blond, he also convinced the locals to support the patients and invite them to their homes. McIndoe kept referring to them as "his boys" and the staff called him "The Boss" or "The Maestro". His other important work included development of the walking-stalk skin graft, and the discovery that immersion in saline promoted healing as well as improving survival rates for victims with extensive burns - this was a serendipitous discovery drawn from observation of differential healing rates in pilots who had come down on land and in the sea. His radical, experimental treatments led to the formation of the Guinea Pig Club at Queen Victoria Hospital, Sussex. Among the better known members of his "club" were Richard Hillary, Bill Foxley and Jimmy Edwards.