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Editorial Plastic and Aesthetic Research

Fifty-six years of plastic surgery

Thomas M. Biggs
Baylor College of Medicine, Houston, TX 77007, USA.
Address for correspondence: Prof. Thomas M. Biggs, 50 West Terrace, Houston, TX 77007, USA. E-mail: tbiggsmd2@aol.com

Evolution is the natural state of all things and certainly To deal with these problems the allied forces organized
our field of plastic surgery is not exempt. The appearance a unit under the direction of Sir Harold Gillies
on the scene of a new journal dedicated to the pursuit (in private life an otolaryngologist) and surgeons
of excellence is no exception. It is my distinct pleasure working in this unit were treating many of the problems
to become the Editor-in-Chief of Plastic and Aesthetic previously deemed irreparable. After the war, the body of
Research and to help guide it into the evolutionary process knowledge and experiences achieved from these efforts
so it can play its role in the advancement of methods to were disseminated to all parts of the world giving birth
make people’s lives better. to organizations of like-minded surgical adventurers who
called themselves “plastic surgeons”… from the Greek
Plastic surgery is an exceptional field. It is not word “plastikos” or to form, mold, or make new. It was
regionally-based or system-based. It is not cardiovascular impossible to limit themselves to one system or to one
surgery; it is not genitourinary surgery; it is not ear, nose, region. The description that best identified their specialty
and throatsurgery. Then what is it?
was innovation… and that is what we plastic surgeons
We know in ancient India forehead flaps were being are… innovational surgeons.
used to reconstruct noses, which had been amputated as
punishment for adultery. This was surgery necessitating The evolutionary process moved rapidly after World War I
familiarity with random flaps. Therefore, it is reasonable to and even more rapidly during World War II and the years
assume that random flaps were probably being employed succeeding it. My personal observation of the process
in other reconstructive problems; however, we have no began during my residency in 1958. We were doing cleft
credible proof of this. We do have proof of skin grafts, lips by the Tennison technique as Ralph Millard had not
rhinoplasties, face lifts and a variety of other aesthetic yet become well-known. The full understanding of fluid
and reconstructive procedures being done in 19th century and electrolyte physiology in burn patients, as well as
Europe, but not by surgeons who were organized and today’s commonly known knowledge of burn wound
worked collectively to promote the spread of common care, had not come on the scene. The rare face lift was a
knowledge. This did not occur until the advent of World simple skin stretch technique as Mitz and Peyronie were
War I. still in training and the superficial musculoaponeurotic
system was unrecognized. The open rhinoplasty was
During World War I, medicine advanced. Individual reserved for nasal reconstruction with cleft lip. Open
military personnel with injuries of massive degree, aesthetic rhinoplasty was generally unheard or were mere
which heretofore had been fatal, were being saved. fantasies. IIIous and liposuction were decades away as
However, resulting traumatic sequelae were well-beyond was Uebel and Barrera’s single follicle method of hair
the knowledge of contemporary treatment modalities. restoration.
Access this article online The list of operative evolution goes on and on; but, plastic
Quick Response Code: surgery advanced in other skills as well as in techniques.
Website: Our anesthesia was ether, with cyclopropane coming in
www.parjournal.net
a bit later; but, both of these were explosive; therefore,
ruling out use of an electro-cautery. It was all clamp and
DOI: tie for hemostasis (a big problem as we were not aware of
10.4103/2347-9264.135529 aspirin’s effect on coagulation) or local. The only sedation
we had with local was an assortment of barbiturates.

Plast Aesthet Res || Vol 1 || Issue 1 || Jun 2014 1