Early plastic surgery set stage for today's practices

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The word "plastic" in "plastic surgery" evolved from the Greek word "plastikos," meaning "to mold."

The first textbook on plastic surgery was written by Gaspar Tagliacozzi in the 1500s. He wrote about reconstruction of noses after trauma.

The first breast augmentation was done in 1895, when tissue from the back was transplanted to the breast.

The first implantable materials were implanted into the breast in 1899. They included paraffin, beeswax, vegetable oil, industrial silicone, and Ivalon sponges. I personally removed a number of these decades ago. Thankfully, none lately. They felt like lumpy bricks.

The father of modern-day plastic surgery was Jacques Joseph, particularly because of his work in rhinoplasty, around the turn of the last century. His techniques and surgical instruments are still used today.

Plastic surgery grew with reconstruction of injuries during World War I. Plastic surgeons then became involved in peace time injuries including burns, facial fractures from automobile accidents, and injuries at work and on farms with the advent of automated machinery.

Also, reconstruction for birth defects, such as cleft lip, cleft palate and cancer, were needed. Prior to "cosmetic" surgery, these were a plastic surgeon's main focus.

When Hollywood movies began, female movie stars were among the first to request cosmetic surgery. A tragic example was Hedy Lamarr, who sought out a plastic surgeon and told him where she wanted skin removed and where she wanted fillers injected in her face. At the time, he probably used industrial silicone.

Apparently, the results were disfiguring to the point that she became a recluse and would not even let her children see her until her death.

Breast enlargement became popular in the 1960s after the famous Carol DoDa, a topless dancer in San Francisco, had large amounts of silicone injected into her breasts. The results were spectacular as far as size went, but were hard and lumpy - and looked like it.

These first requests lead to a boom in plastic surgery for the everyday person.

Silicone breast implants were developed and thousands of women flocked to plastic surgeons for breast enlargement. At the same time, the request for "nose jobs," eyelid lifts, facelifts, breast uplifts and reductions, ear pinning and many other cosmetic procedures became popular.

Liposuction was invented around 1980, and has since become the most popular cosmetic procedure.

Today, with the majority of people working and with little or no down time for cosmetic procedure recovery, there has been a demand for non-surgical procedures. From this came the birth of such options as Botox and Dysport, fillers such as Juvederm, Sculptra and Restylane. Additionally, lasers and radio-frequency devices, automated hair transplant equipment, and cosmeceutical skin care systems have become mainstream.

There is still a need for reconstructive surgeons, but the demand for cosmetic surgery is very common now. With cosmetic dentistry, hair dyes, youthful clothing, and cosmetic surgery, the grandmothers of today look vastly different from the photos of grandmothers of the past.

Cosmetic surgery and procedures are not important to everyone, but for those seeking to look as young as they feel, it is now available and affordable for more people.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com

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