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History of Plastic Surgery

Figure 1: The Ancient Origins of Plastic Surgery (Reproduced from The Plastic Surgery Institute of Southeast Texas (n.d.)).

Egypt, 1213 B.C.

In ancient Egypt, it was believed that one's face was the only physical attribute that carried over to the afterlife.
Ramses II, an ancient Egyptian king, was noted for having a very large, elongated nose.
So to ensure he was recognized and received as a king in the Afterlife, his mourners surgically inserted bone and seeds into his nose, thus creating the first known record of plastic surgery.

India, 600 B.C.

In ancient India, the noses of criminals and adulterers were cut off for permanent public shame.
Hoping he could encourage forgiveness and reduce public shame, Sushruta created a surgical procedure to reconstruct the nose of ex-criminals.
The process required removing a section of skin from the individual's cheek or forehead, which was then applied to the nose.

Rome, 100 B.C. – 5th Century A.D.

Procedures for wealthy women whose ears had become stretched by the weight of their earrings.
Freed slaves underwent procedures to remove or cover the brands used to mark them as property.
Roman doctors would try various reconstructive procedures on the constant supply of disfigured Roman soldiers.

The most famous Roman Plastic Surgeon

Aulus Cornelius Celsus wrote the definitive De Medicina, a “How To” guide for various plastic surgery procedures on the face and nose.
Celsus’ book was the plastic surgeon’s reference guide for more than 1,700 years.

Anesthesia and tools in ancient surgery

Roman doctors used opium capsules and alcohol pain relief, but patients were always awake during the procedures.
The Romans used primitive versions of the same tools plastic surgeons use today, including forceps, scalpels, and bone drills.

Plastic surgery plays Roman Politics

After being overthrown, Roman Emperor Justinian II’s nose was amputated in an effort to prevent him from regaining the throne.
To the Senate’s dismay, the ousted emperor got a nose job while in exile. After returning to Rome with his new nose, Justinian II regained the throne where he ruled for several years until his execution.

India & Italy, 9th – 12th Century A.D.

The Islamic conquest of India and parts of Europe brought with it plastic surgery techniques, including Sushruta’s procedure for rhinoplasties.
After learning the “Indian Method” from his father, Antonio Branca created the “Italian Method” of rhinoplasty.
Instead of taking skin from the cheek or forehead, Branca took skin from the forearm.
Although it creates less scaring, Branca’s method required the forearm to be awkwardly attached to the nose for 20 days.

Germany, 1818

It wasn’t until 1818 that the word ‘Plastic’ was used to describe cosmetic surgery.
Derived from the Greek word, “plastikos” meaning to mold or give form, the phrase “Plastic Surgery” was first used by Karl Ferdinand von Graefe in his now famous Rhinoplastik.

USA, Today

In 2010, over 1.6 million people underwent plastic surgery procedures, worth a total of $10.1 billion.
40% of people having plastic surgery have already had one procedure, a customer retention rate higher than many other industries.