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Background of Plastic and Cosmetic Surgery in the Modern and Ancient World
Today, here, and around the world, many people have considered
having Cosmetic Surgery, or Plastic Surgery performed. Many more
have had plastic surgery done, some with multiple procedures.
Plastic Surgery, by definition, is a broad term for operative
manual and instrumental treatment which is performed for
functional or aesthetic reasons. Medical treatment for Facial
injuries dates back over 4,000 years. The word "plastic" is a
derivative of the Greek word plastikos meaning to mould or
shape; however, contrary to common belief, the term "plastic
surgery" is not related to modern plastics at all.
Cosmetic Surgery was first known to have been performed in Roman
times. The Romans had the ability to perform simple procedures
such as repairing damaged ears, in modern times referred to as
Otoplasty, this is one of the most simple of procedures. One
report discusses a patient getting his earlobes repaired after
years of wearing heavy earrings. The excess lobes were trimmed
and the hole sewn together. One of the more expensive plastic
surgeries performed at the time, the removal of branding and
scars, was a commonly executed procedure. Freed slaves paid a
high price indeed for this type of surgery. It was felt that
this common practice reduced the stigma of having been a slave
in this ancient times. In ancient India physicians were able to
use skin graft reconstruction techniques as early as 800 B.C.
From ancient times to the early nineteenth century, we find a
living tradition of plastic operations of the nose, ear and lip.
The Kangra (correctly pronounced as 'Kangada') district in
Himachal Pradesh was most famous for its plastic surgeons. Some
scholars are of the opinion that the word 'Kangada' is made from
'Kana + gadha' (ear repair). The British archaeologist Sir
Alexander Cunningham (1814-93) had written about the tradition
of Kangra plastic surgery procedures. We also have information
that in the reign of Akber ,a Vaidya named Bidha used to carry
out plastic operations in Kangra. The Charaka-Sanhita and the
Sushruta-Sanhita are among the oldest known manuscripts on
Ayurveda (the Indian science of medicine). Chronologically
speaking, the Charaka-Sanhita is believed to be the earliest
work, and deals with medicine proper and containing a few
passages on surgery. The Sushruta-Sanhita, a work of the early
centuries of the Christian era, mainly deals with surgical
knowledge rather than medicine. The extant Sushruta-Sanhita is,
according to its commentator Dalhanacharya (of twelth century
AD), a amendment by Nagarjuna. The original Sushruta-Sanhita was
based on a series of lectures between Kashiraj Divodas (or
Dhanvantari) and his disciples, Sushruta and others. In 15th
Century Europe, a man by the name of Heinrich von Pfolspeundt ,
a German physician and a member of the Teutonic Order of Knights
was one of the first known Europeans to have performed cosmetic
surgery. Dr. Pfolspeundt was one of the first doctors of the
late medieval and early Renaissance period to take medical
practices beyond the very crude conditions that had existed
through much of the Middle Ages. During his time, a good number
of German physicians, especially those in Strasbourg, helped to
serve the advancement of the study of medicine. Dr. Pfolspeundt
described a procedure to make a new nose for a person who lacks
one. He stated that by removing skin from the back of the arm
and suturing it into place a new nose could be created. From
Italy we have records that would indicate
that in the year 1442,
Branca, a surgeon of Catania in Sicily, carried out plastic
surgery of the nose, Also known as rhinoplasty, using a skin
flap from the face. This procedure was very similar to the one
described in the Sushruta-Sanhita, an Ayurvedic compendium
composed in the early centuries of the Christian era. His son
Antonio continued his work and was the first known to use a skin
flap from the arm for reconstructing the nose. The Boinias
family carried on with his work. The plastic operations carried
out by the Boinia brothers are described in a book published in
1568 by Fioravanti, a doctor of Bologna, Italy. At the hands of
Gasparo Tagliacozzi (1546-99), a professor of surgery and of
anatomy at the Bologna University, that plastic surgery attained
wide fame in Europe. His book De curtorum chirurgia per
insitionem (The surgery of defects by implantation), printed in
1597, was the first scientific composition on plastic surgery.
Tagliacozzi had described a method of substitution of the nose
by skin from the arm and of replacement of the ears and lips,
demonstrating his work throughout his manuscript by way of a
large number of illustrations. The Church dignitaries of the
time regarded cosmetic surgery as an interference in the affairs
of the Almighty. After his death they not only excommunicated
Tagliacozzi, but also had his corpse exhumed from its church
grave, and placed it in unconsecrated ground. The great Voltaire
(1694-1778) wrote a satirical poem on Tagliacozzi and his
operation on the nose, using flap from the buttocks.
However, due to the many dangers of surgery in those times,
cosmetic surgery was rarely performed until around the 1900's.
The United States first plastic surgeon was Dr. John Peter
Mettauer, born in Virginia in 1787, who in 1827 performed the
first cleft palate surgery on record with instruments he himself
designed.
There are two very broad fields of aesthetic surgery, Cosmetic
Surgery and Reconstructive Surgery. Reconstructive surgery,
including microsurgery, focuses on undoing or masking the
destructive effects of trauma, previous surgery or disease.
Examples of such operations are the rebuilding of amputated or
damaged arms or legs; repairing cleft palates or lips, badly
formed noses, and ears; and reconstructing a breast after
mastectomy. Reconstructive surgery may include moving tissue
from other parts of the body to the affected area.
Cosmetic surgery however, is an elective surgery, usually done
more for aesthetic reasons rather than to repair an injured
area. In many cases, however, there are medical reasons for
having some procedures done, such as breast reduction (for back
pain relief) and Mastopexy (also known as a "breast lift).
Cosmetic Surgery includes, but is not limited to,
Abdominoplasty, or "tummy tuck", Blepharoplasty, or "eyelid
surgery", Augmentation Mammaplasty, or "breast enlargement", and
Rhytidectomy, or "face lift". There are many more procedures not
listed here that are commonly performed as well. The top five
surgical procedures in 2004 Liposuction (325,000), nose
reshaping (305,000), breast augmentation (264,000), eyelid
surgery (233,000), and facelift (114,000).
As you can see, Plastic Surgery has a longstanding history
across the ages. It has helped not only in the reconstructive
plastic surgery field but also has allowed people to feel more
comfortable with their bodies and more confident about
themselves.
About the author:
None
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