History of facial plastic surgeries and procedures
by Lifestyle Blogger Sophie Andersen
Though facial reconstruction and related surgery techniques have become widely popular in the past 20 years, most people do not know that procedures to embellish the facial and hairline area have been around for far longer than the last two decades of the 20th century. In fact, the first records of procedures resembling contemporary plastic surgery date as far back as the ancient India, though the implements and techniques used at the time were highly primitive compared to their modern-day equivalents. Let’s take a quick look at the history of facial plastic surgery from its origins to this day, shall we?
Hair restoration procedures: The beginnings of hairline surgery
Problems with hair are not restricted to the modern man alone, as shown by the first written records of hair transplantation surgery that date back to 1822. In a study published in Wurzburg, German polymath Johann Friedrich Dieffenbach described experimental surgery procedures himself and his mentor Professor Dom Unger performed on animals and humans which led to the first successful hair transplants from one area of the scalp to another. Several pieces on similar hair transplantation procedures appeared in the next few decades, but the first serious procedures using hair-bearing skin grafts and flaps were not performed before the late years of the next century. It was in the 19th century that transplantation procedures became commonly used on a number of occasions to treat traumatic alopecia (human baldness resulting from burns and other injuries), and various nostrums and concoctions devised by medicine men and snake-oil salesman appeared as a common remedy for male-pattern baldness.
Modern hair graft transplants: Development of contemporary hairline surgery
Modern surgical procedures to transplant hair first appeared in Japan in the 1930s and 1940s with dermatologist Dr. S. Okuda as one of the pioneers in the field, but it was only after World War II that these techniques spread to Europe and the rest of the world. In his records, Dr. Ocuda described a procedure to transfer full-thickness hair-bearing scalp grafts to hairless areas to correct hair loss on the eyebrows, scalp and moustache area, and several similar surgeries were reported as equally successful throughout Japan in the course of the coming years. In 1959, hair transplant procedure took its true modern shape with a paper on hair surgery technique by Norman Orentreich, MD, who introduced the concept of donor dominance and recipient dominance as deciding factor for transplant success that soon gained acknowledgement and popularity among hair restoration surgeons worldwide. From then on, hair transplants and related harvesting and transplantation procedures and the science behind it started developing at an unabated pace, resulting in the contemporary techniques that range from the simplest ‘plug-type’ transplants to the advanced microsurgical procedures, micrografts, use of single follicular-units as a gold standard in transplantation procedures and science-based medical treatments to remedy hereditary hair loss.
The origins of facial plastic surgery: The early masters of facial procedures
In the world of plastic surgery and corrective procedures, one of the first areas to receive surgical attention was the nose. Early otoplasty techniques to correct defects and deformities of the nose date back to the 5th century BC and ayurvedic physician Sushruta and his medicine students who performed the first known reconstruction and correction procedures on the ear, lips, nose and genitalia in individuals whose bodies were mutilated as a form of religious, criminal and military punishment. The records of these procedures were preserved in Sushruta’s medical compendium known as the Sushruta samhita (Sushruta’s Compendium dated cca. AD 500) and the techniques described there were practiced throughout Asia up until the late 18th century.
The middle ages: Plastic surgery and its early records in Europe
According to the seminal work ‘Buch der Bündth-Ertznei’ by Heinrich von Pfolspeundt in 1460, one of the first successful nose jobs performed in Europe was carried out by surgeon Antonio Branca, but it was only a century later that the procedure received popularity among European surgeons. As the discipline developed, plastic surgeons in the 1800s turned to ancient India for inspiration and expertise and among them, Friedrich Dieffenbach (cca. 1840) was recorded as one of the pioneers in various fields of plastic surgery from otoplasty to rhinoplasty. In this era, first facial skin grafts appeared and reports of their use were first published in the ‘Gentleman’s Magazine of Calcutta’ in October 1794. Use of skin grafts soon became popular as the ‘Indian Method’ in facial reconstruction operations and grafting procedures have been performed following a similar pattern ever since. The facial restoration field further developed with Felix Jean Casimir Guyon of Paris and Jacques Reverdin of Geneva starting with 1869, who used the type of skin transplant techniques much the same as the ones we have today. In World War I period, surgeons like Archibald McIndoe and Harold Gilles refined skin grafting techniques like the ‘tubed pedicled graft’ to treat severe burns and similar facial injuries. In 1942 after the Battle of Britain, these procedures received an additional push with McIndoe’s and Gilles’ operation on burn airmen in the Queen Victoria Hospital, and in the decades to come, facial restoration has joined the mainstream, with rhinoplasty and otoplasty becoming a straightforward routine procedures increasingly popular across the continents.