Trench Warfare to Botox: Plastic Surgery As a Modern Innovation

[ 0 ] April 21, 2014 |

What started as a way to aid wounded warriors on the battlefield has become an everyday practice, with  plastic surgery creating what may be perceived as’the enhanced human being’


One of the top 5 modern innovations as noted recently by Slate is the field of plastic surgery. Over the course of time, plastic surgeryhas evolved from being life-saving to also becoming life-enhancing. Indeed, I tell my patients that although some of the procedures we perform are relatively short, there are procedures that take many hours in the operating room. However, in this day and age anesthesia is relatively safe, and the large majority of patients recover well; indeed, plastic surgery procedures may be life-saving in a percentage of patients, however, many procedures that plastic surgeons perform really change the quality of life, and certainly hopefully for the better.

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The word “Plastikos” is of Greek origin meaning “fit for molding.” The history of this specialty dates as far back as 600 BC where the famed Indian physician Sushruta described procedures for reconstruction of the nose and earlobe. Since then various other concepts that are still in use today were introduced. The renaissance in plastic surgery emerged in Italy in the 14th century and reached its peak in the 15th and 16th centuries during which time the foundations of modern anatomic studies were developed. The term “Plastique” was first coined by Desualt in 1798 and later popularized by Zeis in 1839. Most attribute the development of modern plastic surgery to World War I. The advent of trench warfare resulted in increased numbers of maxillofacial injuries necessitating the need for facial reconstruction. The restoration of facial anatomy was seen by generals as a requirement rather than an indulgence; serving as means to restore troop morale and so was endorsed. After the war, specialized centers were set up in the United States to treat patients returning from Europe. It was during this time that aesthetic or cosmetic surgery began to appear. From then on, emphasis was placed on teaching plastic surgery. Plastic surgery procedures evolved to public spectacles in which an operation would be performed in front of a live audience. Famously, the actress Fanny Brice underwent a nose job at the New York Ritz in front of a live crowd in 1923!

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During World War II, physicians were required to treat complicated craniofacial and extremity fractures, and repair burned and frostbitten areas as well as paraplegic pressure sores. It was during this period that importance was given to the development of hand surgery and for the treatment of burns. After the war, the concept of sub-specialization was introduced. Plastic surgeons could return home and continue to work in their chosen field. Elective surgery also grew in popularity particularly for the treatment of facial scars, surgeryclubbed feet, and congenital defects. The 1960s and 1970s saw marked advancements in the specialty; new surgical techniques were introduced, the number of practicing plastic surgeons increased, and public awareness of the specialty was on the rise. With time, procedures become more routine and much safer. Both men and women were now able to alter their appearance based on their own perceptions of beauty.

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Today, preconceived biases associated with the nip and tuck notion of plastic surgery have progressively decreased. The American Society of Plastic Surgeons reported that over 1 million cosmetic surgical procedures and over 13 million cosmetic minimally invasive procedures were performed in 2012 alone, a 98 percent rise from the year 2000 and this despite the current economic setting. Minimally invasive options such as Botox, fillers and chemical peels are becoming increasingly popular and have for some become a routine part of life.

Plastic surgeons interface with physicians and surgeons from literally head to toe. For instance, in any given week I may work with a breast surgeon, dermatologist, head and neck specialist, and general surgeon on different patients! Plastic surgery is a broad field that takes care of patients from the youngest (cleft palate and lip patients) to the oldest, and everyone in between. Plastic surgeons are involved in reconstructive and aesthetic procedures, from Botox treatments to face and hand transplantation. Plastic surgeons work with breast surgeons, general surgeons, neurosurgeons, orthopedic surgeons, trauma surgeons, head and neck surgeons, vascular surgeons, and heart surgeons only to name a few groups. Many of us very fondly remember Dr. Robert Goldwyn, an international, kind, well-renowned plastic surgeon in Boston, and to paraphrase one thought he quipped on occasion was, “Reconstructive surgery may become aesthetic surgery at some point.” I had the honor of seeing him in weekly conference for a time years ago.

Samuel Lin 7a

Dr. Samuel Lin

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The evolution of this specialty has mirrored the ever changing environment within which we live. What started as a way to aidwounded warriors in the battlefield has now become an everyday practice serving to create what may be perceived as “the enhanced human being.”

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Category: Beauty & Fashion, Lifestyle

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About Dr. Samuel Lin: Dr. Samuel Lin is a Plastic Surgeon and Assistant Professor of Surgery at Harvard Medical School. He is Site Director for the Harvard Plastic Surgery Residency Training Program at Beth Israel Deaconess Medical Center. His [...]
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