Dr John Newton, Australasian Society of Aesthetic Plastic Surgeons (ASAPS) Board Member and Specialist Plastic Surgeon working in the Newcastle and Hunter regions explains the history of plastic surgery.
Plastic surgery is at least as old as Ancient Egypt, predating things like anaesthesia and antiseptics by several millennia. The Edwin Smith Papyrus is the oldest known medical text that discusses trauma and surgical procedures. It was so named for the American “Egyptologist” who purchased the ancient text in the late 19th century. The text itself has been dated to roughly 2500 to 3000 BCE and is alleged to contain descriptions of broken noses and their repair. The reconstructive efforts of the ancient Egyptians ring true of rhinoplasty, and as such the text is generally considered to contain the earliest known mention of plastic surgery.
There is ample evidence suggesting reconstructive surgeries were taking place in ancient Rome and India as well.
In some Asian countries there was an unsavoury habit of amputation of the nose of persons guilty of adultery. Records suggest that plastic surgery was used as far back as those times to attempt to reconstruct noses. It is true that this tradition still exists in some Pacific Islands. I have in fact been involved with the reconstruction of noses, ears and eyelids in the Pacific Islands for exactly this problem.
Plastic surgery continued its course over the centuries that followed in its attempts to return the function and appearance of patients to normal. The archives of surgeries used are very interesting to look at.
The 1900’s saw plastic surgery begin to develop its cosmetic interest. Breast augment procedures date back to the nineteenth century and face lifts date back to the end of the nineteenth century. These cosmetic surgeries have followed on from the plastic surgery which had preceded them. Over the last 100 years Plastic Surgeons have further explored and developed cosmetic surgery into the field that we know today.
Both nationally and internationally the vast majority of cosmetic surgery is performed by Specialist Plastic Surgeons.
Internationally there are societies for cosmetic surgery. They include the International Society of Aesthetic Plastic Surgery throughout Europe. The American Society for Aesthetic Plastic Surgery within the United States and the British Association of Aesthetic Plastic Surgeons in the UK. Australia’s corresponding body is of course the Australasian Society of Aesthetic Plastic Surgeons (ASAPS).
To be a member of these Societies a surgeon has to be a qualified Plastic Surgeon and a member of the Plastic Surgery Speciality group within their country. Persons who are not qualified Plastic Surgeons are not admitted to these national and international groups. In Australia, this would constitute as a Fellow of the Royal Australian College of Surgeons (FRACS).
Training in cosmetic surgery for Specialist Plastic Surgeons has been integrated into plastic surgery training courses. This is a prolonged period of training involving both Public Hospital and Private Hospital training and apprenticeship in both plastic and cosmetic surgery.
This extensive training ensures that Specialist Plastic Surgeons are not “skin deep” surgeons. Specialist Plastic Surgeons have a thorough knowledge of the surgeries they perform, including cosmetic surgery. They have a profound knowledge and understanding of the needs of patients undergoing cosmetic surgery, the potential problems of cosmetic surgery and how to manage those problems.
ASAPS members are provided with exclusive ongoing education programs to maintain and upgrade their knowledge and skills regarding cosmetic surgery. Every member is also required to undergo an annual assessment by the Royal Australasian College of Surgeons to ensure that they remain current and safe in their practice.
In short cosmetic surgery has been the domain of Specialist Plastic Surgeons throughout its history and it remains primarily within their domain.
It is appropriate that a person considering cosmetic surgery, critically look at the surgeon providing their surgery and ensure that they feel comfortable with that person and with that person’s capacity, training and qualifications. The ASAPS Member’s database is a good place for you to start your search.