The History of Cosmetic Surgery dates back to the Greeks. The word plastic is from the Greek word plasticos for "to fit or mold" and this still a part of the mission of plastic surgeons today. They are re-shaping the human body to make the person less self-conscious, more acceptable by the standards of the society in which they live. Although as the world revolves around only one person, yourself, it is sometimes difficult to just step back and wait. Wait and another night may change the way one perceives the world and themselves.

Some people cannot wait. In actuality, the majority of cosmetic or plastic surgery is not done on patients with glamorous names or a great singing voice. Plastic surgery in its highest form deals with issues of a person’s sense of self that the majority of people never have to face. Plastic surgery has gotten more bad press and has faced more than its share of jeering comments due to the world’s view of what is beauty and the world’s ability to pay someone to make them fit that idea of beauty. That is not what this article will deal with this week. This week the history and the mission of cosmetic surgery needs to be uplifted (pardon the irresistible pun!)

One of the earliest documented cases of reconstructive surgery was in 800 BC, in India. Rhinoplasty and otoplasty are described in detail by Sushruta Samhita and was presented in detail as late as the 18^th century in The Gentleman’s Magazine. However, medicine itself was slow to evolve and so was cosmetic surgery. In the 15^th century, there were documented accounts of how to make a new nose for a person who had had their nose bitten off and devoured by a dog, though it was not until much later that any form of Rhinoplasty became a safe and common practice.

One of the hardest obstacles to overcome in plastic surgery was pain. This was due to the fact that proper anesthesia was not yet developed. Add to that the high risk of infection and you begin to sense why it has taken so long and what huge hurdles had to be overcome to bring us to where cosmetic surgery is today. From 1792 to 1928, the most commonly performed plastic surgery involved the nose. There are many birth defects associated with the nose and physicians from around the world were able to develop many procedures that successfully gave a sense of self-confidence to their patients.

It was not until the 19^th century that Dr. John Peter Mettauer performed the first cleft palate surgery. This operation, so common today and done so early in a child’s life, was in 1827 with instruments Dr Mettauer had to design himself! The 20^th century and the Great War also presented many challenges for all physicians and the plastic surgeons were able to improve the lives of thousands of veterans who had given of themselves for the defense of our country. A New Zealander, Sir Harold Gillies was an otolaryngologist developed many of the techniques still performed today for facial reconstruction due to facial trauma. In 1931 the American Society of Plastic and Reconstructive Surgeons (ASPRS) was formed and physicians must pass a qualifying exam to have the honor of being board certified by the ASPRS. Still, it was not until the 1960’s and 1970’s that the realm of plastic surgery expanded and changed, allowing many genres and areas of specific expertise to each plastic surgeon. N 1969 President Nixon appointed ASPS member, Dr. Hal B. Jennings as Surgeon General. Dr Jennings was the first and only plastic surgeon to be awarded this honor.

The founder of the ASPS, Jacques Maliniac, also formed the Plastic Surgery Educational Foundation (PSEF) in the late 1940’s and this organization has as their mission statement to support research aimed at advancing information and education on congenital and acquired deformities. This is the true mission of the plastic surgeon, to re-mold congenital and acquired deformities in order to create a life of hope and happiness for their patients.

One of my favorite Star Trek shows was the one where this female pilot crash-lands on another planet where no one there knew what a human looked like. However, the inhabitants of the planet were highly intelligent; their culture was far more advanced than any other planet, indeed, any other solar system. The people of the planet reshaped, refitted, and molded the pilots’ broken body into another form. A form that worked for the purpose of life, but gave no quality of life for the female pilot. However, the people were not without empathy. When the female pilot woke to find her body horribly misaligned, the people of the planet gave her mind the ability to project how she wanted herself to be seen.

The thing about this one episode that has always perplexed me is why was the female pilot still discontent? She was ashamed and acted as if the crew of the Enterprise would not have anything to do with her if they discovered the truth about her form. The majority of the show is about

hidng the truth about the pilots true form. Humans have been doing this very thing since the world began.

Following the truth as to why the pilot sends a distress call then refuses to leave the planet and the truth of the events leading from the crash to her deciding she must stay on this planet forever is essenially te plot of the show. The mystery is solved, within the appropriate timeline for Hollywood but the question goes on and on without an answer.

It is my opinion that some people cannot be at peace with the way they feel on the inside UNLESS the image they project to the world is Correct, in their own mind’s eye, to the people of the world.

This does not mean that they are wrong to receive whatever they want done for their body in order to give them peace with themselves. It means that until humans are content with their own bodes there will always be a niche for plastic surgeons who do only face-lifts, or liposuction, or Rhinoplasty. It also means that until congenital birth defects are diagnosed and remedied in utero there will also be a place for surgeons who treat only infants with congenital deformities.

The world changes, and the plastic surgeon revolves with those changes.