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Where did the name ‘plastic’ surgery come from? It is probable that the first use of the term was by the German von Graefe in his book Rhinoplastik published in 1818. The intention was to describe the moulding of tissue by surgery and has nothing to do with the use of plastic as a material. The name was used again by another German surgeon, Zeis, who in 1863 published an index of plastic surgery recording literature relevant to plastic surgery from 900 years BC. This was translated by TJS Patterson and published in 1977.

Many people inaccurately equate plastic surgery solely with cosmetic surgery and, although surgery for appearance is an important part of the repertoire, even more so is the treatment and reconstruction of injuries, including burns, cancer and congenital deformities.

Many reconstructive and aesthetic surgical techniques have been described over a period of 2000 years as part of the repertoire of all surgeons. Occasionally there were surgeons who concentrated their skills on what we would now call plastic and reconstructive surgery but it was at the time of the First and Second World Wars that the current concept of a speciality of plastic surgery emerged. Faced with horrendous injuries and aided with modern advances in anaesthesia, resuscitation and antisepsis, groups of surgeons developed ways of reconstruction.

Their inventive minds took on problems that had eluded others and their range of work expanded so that some claimed that they were the true ‘general surgeons’. Now the wheel is turning again with the advent of super specialisation. Some parts of plastic surgeons’ traditional repertoire are being claimed by other speciality groups.

The plastic surgeon is faced with many unique and novel reconstructive problems without any exact precedent and as the father of British plastic surgery, Sir Harold Gillies, taught, it is the principle that is important. Nevertheless, it is important for the surgeon to know what has gone before and study different ways of tackling a problem. There are many instances where opportunities have been lost by the lack of knowledge of what has gone before. Here are two illustrations; Tanisini in 1901 reported a reconstruction using a myo-cutaneous flap from the back.

His report went unnoticed and it was not until 1972 when Olivari described his latissimus dorsi flap that this method of tissue transfer was reborn. Again, Manchot in 1889 wrote a treatise on the anatomy of cutaneous circulation but it was 80 years before this was reinvestigated and the importance of this knowledge used to design so many of the present flap reconstructions.

The developments in reconstruction and aesthetic surgery have been gradual but there have been notable steps frequently associated with a single name, although it often seemed to need two people to bring a new technique into general usage. The first description is amplified by a second person, either knowingly or in ignorance, who then brings the procedure into common use. The tube pedicle technique of tissue transplantation is a case in point. It was originally described by the Russian, Filatov, on 9th September, 1916; independently Gillies devised a tube pedicle to reconstruct the face of a severely burnt sailor on 3rd October, 1917. It was Gillies who influenced reconstructive surgeons to use this technique over the next 50 years.

A ‘timeline’ of developments of surgical techniques with the associated names and dates is shown below. Space does not allow a comprehensive list. Apologies made for errors and omissions and it is hoped that readers will correspond with this publication to give suggestions and corrections.

Study of the timeline below is humbling. It shows the great number of ideas and techniques that have been used in surgery of repair and in correction of deformities by so many inventive surgeons. It illustrates how one person can have several developments to his name and how a new technique described by one person needs a second surgeon to develop and publicise it. Also highlighted are the lost opportunities resulting from a failure to study what has gone before and also the difficulties of language where reports published in obscure journals, in another language, are overlooked. The problem of our time is that the vast number of publications and literature could result in important contributions being missed.


Recommended Reading

  • The Zeis Index and History of Plastic Surgery 900 BC to 1863 AD, translated by TJS Patterson, 1977.
  • The Progress of Plastic Surgery, AF Wallace, 1982.
  • A History of Plastic Surgery, P Sanoni-Rugiu and PJ Sykes, 2007.


Declaration of competing interests: None declared.



1500 BC
Edwin Smith and Ebers Papyri – the treatment of burns is described but there is no description of surgery.
600 BC
Susruta – practical guide to the treatment of tissue loss on the face.
400 BC
Hippocrates – dressings for burns and the use of sea water for cleansing wounds.
200 AD
Galen – dressings for burns.
30 AD
Celsus – wrote de re Medicina in several volumes describing the repair and various flap for hand and facial deformities.
650 AD
Paul of Aegina, Alexandria – seven books on medicine describing treatment of nasal fracture, hypospadias, gynecomastia and operations on the lips and ears.
1000 AD
Forehead rhinoplasty in India.
1457 AD
Branca father and son, in Sicily – carried out nasal reconstructions using an arm flap.
1545 AD
Ambrose Pare – wrote about the classification of burn injuries and introduced the pin prick test. He treated lip clefts and called them ‘hare lip’. He used prostheses for the palatal cleft and a penile prosthesis for those that ‘have their Yards cut off’.
1586 AD
Tagglicozzi – brachial flap rhinoplasty.
1794 AD
Gentleman’s Magazine published an account of a nasal reconstruction in India by the surgeon B Lucas and reprinted this in England and North America.
1804 AD
Baronio – successful auto-graft of skin in sheep.
1814 AD
Carpue, London – used the forehead for four nasal reconstructions (the Indian method).
1818 AD
Von Graef – first used the word ‘plastik’ to describe the moulding of tissue (rhinoplastik).
1819 AD
Roux, France repaired the cleft palate of a Scottish medical student. Von Graefe in Germany disputed the claim to priority as he had repaired a palatal cleft in 1816 but was it successful?
1828 AD
Syme – excised a mandibular tumour.
1832 AD
Dupuytren – described and operated upon the contracture of the hand that bears his name although he wasn’t the first to do so. He also described six degrees of burn.
1836 AD
Liston – removed a maxilla taking only seven minutes!
1846 AD
William Morton, Massachusetts General Hospital – administered anaesthetic for surgery.
1847 AD
Velpeau – wrote about the ‘restoration of destroyed parts and repair of deformities’ and reported the successful ‘take’ of skin torn from a finger.
1863 AD
Zeis of Dresden – published a bibliography of plastic surgery. This was translated by Patterson and published in 1977 (essential for those interested in the history of plastic surgery).
1867 AD
Joseph Lister – introduced antiseptic surgery.
1869 AD
Reverdin – pinch grafts of skin.
1870 AD
Pollock, London – first to skin graft a child with burns.
1872 AD
Ollier, Lyon – described the use of sheets of skin graft.
1874 AD
Thiersch – described the use of sheets of epidermis and devised a knife to cut them.
1875 AD
Wolfe, a Hungarian eye surgeon working in Edinburgh – used a full thickness skin graft to repair an eyelid. In 1893 the German, Krause, popularised the use and hence it is often called a Wolfe-Krause graft.
1884 AD
Cocaine and the introduction of local anaesthetic – prominent early users were Halstead and Harvey Cushing. Lignocaine synthesised in the 1930s.
1889 AD
Manchot, a Swiss doctor working in Strasbourg – researched and published the anatomy of the cutaneous circulation. Sadly his work went unnoticed as it would have initiated the development of so many reconstructive procedures which originated in the 1970s and after.
1891 AD
Keegan, India – wrote about the need to provide lining for nasal reconstructions to prevent collapse and shrinkage. This re-stated Dieffenbach’s findings in 1826 and preceded Gillies comments on the same.
1897 AD
Poussan – breast reduction.
1898 AD
Abbe, USA – surgeon who described the flap reconstruction of the lip which bears his name although it had been described by the Italian Sabatini 60 years previously. He carried out a vaginaplasty by epithelial inlay, was a hand surgeon of note and, influenced by Madame Curie, investigated the treatment of cancer by radium.
1901 AD
Le Fort – researched and described facial fractures although they had been reported in less detail by Guern previously.
1903 AD
Gersuny, Vienna – had the ignominy of publishing the use of Paraffin wax for breast augmentation which caused many problems.
1906 AD
Tansini, of Italy – described the Latissimus Dorsi flap for breast reconstruction but the technique was overlooked until rediscovered in 1970.
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Robert Boyle Monkman

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