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Cosmetic Surgery

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Cosmetic Surgery

Whilst the thirst for cosmetic procedures is much greater in Brazil and the United States, cosmetic surgery in the UK is rising. People can now play God with their bodies and no longer just use plastic surgery for injuries or out of necessity. But it wasn't always this way... read on to find out more!

Ancient plastic surgery

Many ancient civilisations experimented with plastic surgery. In Ancient Egypt, doctors and physicians seemed to use some modern surgical methods. Archaeologists found some prosthetics in a mummified toe and they used splints to hold in place nasal injuries. However, the most influential figure in ancient plastic surgery came from India, his name was Sushruta.

Sushruta (below) was a physician from Ancient India, born in 800 BC. During his life, a gruesome punishment was widespread throughout his country. Removal of the nose was the price you had to pay for crimes such as cheating or corruption. As a result, there was a large demand for reconstructive surgery. In his instructive book, "Sushruta Samhita", the surgeon detailed how he would remove the skin from cheeks or foreheads to help noses regrow. Sushruta's creative idea was in many ways a predecessor to the skin grafts of today.

Cosmetic Surgery, Reconstruction of Sushruta's (left) surgical methods in Kolkata, India, Photographer, StudySmarterReconstruction of Sushruta's (left) surgical methods in Kolkata, India, Photographer: Biswarup Garay, Creative Commons 3.0, Wikimedia Commons

Plastic surgery history: timeline

While Sushruta was certainly a pioneer, there were many more developments that had to occur before we could recognise cosmetic surgery as we know it today. Let's examine plastic surgery's growth through the ages, from a necessity to a cosmetic privilege! But first, we need to brush up on some medical terms.

Term Definition
AnaestheticAn anaesthetic is a substance that allows the body to resist pain. There are two types of anaesthetic: "general" (makes a patient unconscious) and "local" (targets and numbs specific areas of pain).
Cleft lip and palateA cleft is a split that can be in the lip or the roof of the mouth. It is the most common facial defect, affecting people from birth and in severe cases causing difficulties when speaking and eating.
MaxillaThe upper jaw bone in a human. This is often affected by facial injuries.
ProstheticsThe replacement of a body part with an artificial item. Nowadays, these are very sophisticated.
Skin graftA surgical procedure where some healthy skin from one part of the body is used to rebuild damaged skin tissue on a different body part.

Cosmetic Surgery, Drawing of a baby with a cleft lip, StudySmarterDrawing of a baby with a cleft lip, Wikimedia Commons

YearDevelopment
1575Ambroise Paré, a French surgeon, described his use of artificial limbs as a surgeon on the battlefield in his book "The Collected Works of Ambroise Paré". He also used instruments such as the "obturateur" to treat and reconstruct cleft palates. The book acted as a manual for surgeons to use more precision during reconstructive surgery.
1586Italian Gaspare Tagliacozzi used the brachial flap (on the arm) to replace facial tissue for his rhinoplasty (nose reconstruction).
Nineteenth Century
1804Another Italian Giuseppe Baronio tried out the use of skin grafts on sheep.
1814In London, Joseph Carpue brought back the forehead skin grafting techniques that he learned from spending time in India. He used Sushruta's methods of nasal reconstruction, performing the first plastic surgery in Britain.
1818

Karl Ferdinand von Gräfe practised Carpue and Sushruta's techniques in Germany and coined the term "rhinoplastik" which referred to the moulding of nasal tissue.

1827US doctor John Peter Mettauer focused on the cleft palate, performing the first effective surgery with his homemade tools.
1828Guillaume Dupuytren diagnosed six different degrees of burn severity
1837Robert Liston successfully removed the maxilla of a patient to get rid of a cancer tumour.
1838In Germany, Eduard Zeis produced the first plastic surgery textbook, coining the term "plastiche chirurgie" (plastic surgery).
1853After James Simpson discovered chloroform in 1847, Queen Victoria used it as a general anaesthetic to give birth.
1869Jaques-Louis Reverdin created the pinch graft which was a new, easier way of grafting the skin using a needle.
1872Ollier developed a method of skin grading known as "split-thickness", which healed quicker with less scarring. In 1886, Thiersch presented a similar technique. The method is now known as the Ollier-Thiersch method.
1875Wolfe established full-thickness skin-grafting.
1884Cocaine began to be used in medicine as a local anaesthetic.
Twentieth Century
1906Using the "latissimus dorsi" method, Iginio Tansini found a new technique for breast augmentation.
1917Harold Gillies opened The Queen's Hospital in Sidcup, London to treat patients with facial injuries from World War I using skin grafts. Walter Yeo, who suffered injuries at the Battle of Jutland, was the first person to be treated.
1948Lignocaine, a synthetic chemical, went into general use and replaced cocaine as a "local" anaesthetic with fewer harmful side effects and quicker onset. The issue with cocaine is that it is highly addictive and can also prove fatal. Until this point, other substances such as procaine (1905) had been used to achieve high efficiency and fewer side effects, but lignocaine was the best of these and is still used today.
1940sDuring World War II, Japanese prostitutes attempted breast augmentation using paraffin and silicone to attract American soldiers. These attempts were ineffective and dangerous.
1946Harold Gillies oversaw a female to male sex reassignment surgery on Michael Dillon.
1951Harold Gillies oversaw a male to female sex reassignment surgery on Roberta Cowell.

Cosmetic Surgery, Walter Yeo before and after his facial reconstruction, StudySmarterWalter Yeo, before and after his facial reconstruction, in 1917, Daily Telegraph via Wikipedia

A brief history of cosmetic surgery

As evidenced by the progress up until now, a large portion of the advances in plastic surgery had been out of necessity - to help reduce the pain of injuries, with the aesthetic reward a secondary afterthought. However, as the twentieth century progressed there were clear signs, such as the fascination with breast augmentation, that plastic surgery's future lay with its cosmetic potential. Now we can explore the recent history of cosmetic surgery, examining some high profile case studies.

Plastic Surgery in the 1960s: Tammie Jean Lindsey

In 1962, Texas mother of six Tammie Jean Lindsey had the world's first silicone breast implants. The plastic surgeons at Jefferson Davis Hospital in Houston had been practising with implants and needed a human test subject. Being self-conscious about her ears, she agreed to test the implants as long as she could also have a procedure to pin her ears back. Unknowingly, Tammie had opened the floodgates for a cosmetic procedure that helped create a new industry. She admitted that she sometimes felt some discomfort, though there were no lasting health issues from the implants. There have been plenty of successful and failed cosmetic procedures since.

Successes

  • 1996: Actress Pamela Anderson revealed that despite her silicone implants, she could still breastfeed.
  • 2010: A full-face transplant in Spain for a Spanish man which took 24 hours with 30 doctors was successful. Previously his face was essentially lost due to an accident.

Failures

  • The 1980s and 1990s: The King of Pop Michael Jackson completely altered his appearance and complexion with many cosmetic procedures, inviting ridicule from the world.
  • The early 1990s: Actress Jennifer Gray, who played "Baby" in "Dirty Dancing" underwent two rhinoplasty procedures to reshape her nose. She has said that after the procedure she lost her identity and career.
  • 2006: Actress Tara Reid admitted deformities due to liposuction and breast augmentation.
  • 2009: Argentine actress Solange Magnano died as a result of injections into her buttocks which spread to her lungs and brain.

Cosmetic Surgery, Pamela Anderson in 2008, Arnaud 25, StudySmarterPamela Anderson in 2008, Arnaud 25, Creative Commons 3.0, Wikimedia Commons

Despite the risks, cosmetic surgery is big business with many celebrities still using it. It can be epitomised by model Katie Price, who explained her reasons for travelling to Turkey during a Covid-19 lockdown as part of her job.

It's like a car - you have an MOT. If you get a scratch or dent on your car, you fix it and that's how I feel with my body.

-Katie Price, Good Morning Britain, 2021

Types of plastic surgery

Whilst plastic surgery procedures are still used for health reasons, cosmetic surgery - solely aesthetic - is become increasingly popular. In the UK in 2018, over 28,000 cosmetic procedures took place, as recorded by the British Association of Aesthetic Plastic Surgeons - a majority of these being purely cosmetic.1

In comparison to the UK, the American Society of Plastic Surgeons recorded 17.7 million cosmetic procedures and 5.8 million reconstructive procedures in 2018.2

ProcedureHealth Cosmetic
Liposuction: removal of areas of body fat that are difficult to shed naturally.
Breast augmentation: increasing and changing the size of breasts so that they are bigger, have a rounder shape and are more symmetrical.
Blepharoplasty: removal of skin and fat from droopy eyelids which can get in the way of vision.
Breast reduction: women with larger breasts may suffer from back pain and seek a reduction in the size of their breasts. Others are embarrassed due to the size of their breasts and would like to draw less attention.
Rhinoplasty: the reshaping of noses. Often referred to as a "nose job", this work is sometimes done to improve breathing.
Facelift: operations that remove wrinkles and aim to make the skin look younger by tightening the face.

Cosmetic Surgery - Key takeaways

  • Ancient Indian physician Sushruta laid the foundations for skin grafts and rhinoplasty. His ideas are still used in cosmetic surgery today.
  • The nineteenth century was a vital one in the development of plastic surgery. The development of different skin grafting methods was paramount for the precise procedures we see now.
  • World War I and the destruction it brought allowed the first plastic surgery hospital to be opened in 1917 by Harold Gillies. This was out of necessity to cure terrible facial injuries.
  • As breakthroughs continued, plastic surgery moved to cosmetic surgery. Nowadays, whilst surgery has health benefits, a lot of it is to improve appearance.

1. https://baaps.org.uk/media/press_releases/1708/cosmetic_surgery_stats_number_of_surgeries_remains_stable_amid_calls_for_greater_regulation_of_quick_fix_solutions

2.https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf

Frequently Asked Questions about Cosmetic Surgery

Cosmetic surgery was invented in Ancient Egypt, where archaeologists have found evidence of prosthetics.

Cosmetic surgery is surgery for aesthetic rather than medical purposes.

Ancient Indian physician Sushruta is credited with discovering cosmetic surgery through his use of rhinoplasty.

Cosmetic surgery is popular because of its increasing availability, the image-obsessed society we live in and the range of procedures available.

Plastic surgery is surgery to rebuild a body part after an injury or a defect whereas cosmetic surgery is surgery that is purely for aesthetic reasons.

Final Cosmetic Surgery Quiz

Question

Which of the following did Sushruta focus on?

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Answer

Nasal reconstruction

Show question

Question

What was found in Ancient Egypt?

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Answer

A mummified prosthetic toe

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Question

What did Gaspare Tagliacozzi use to replace nose skin tissue?

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Answer

The brachial flap from the arm

Show question

Question

Who used Sushruta's methods of nasal reconstruction in 1814?

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Answer

Joseph Carpue

Show question

Question

Why did Robert Liston need to perform surgery on the maxilla?

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Answer

To remove a cancer tumour

Show question

Question

What is chloroform?

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Answer

An anaesthetic

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Question

What did the pinch graft use?

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Answer

A needle

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Question

How many layers of skin did the Ollier-Theirsch method require?

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Answer

Three

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Question

Which of the following was one of the first local anaesthetics?

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Answer

Cocaine

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Question

What did Harold Gillies do in 1917?

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Answer

He opened the first plastic surgery hospital in London to treat World War I soldiers with facial injuries.

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Question

Why did lignocaine replace cocaine?

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Answer

It had fewer side effects

Show question

Question

Who had the first silicone breast implants in 1962?

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Answer

Tammie Jean Lindsey

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Question

Who died as a result of cosmetic procedures?

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Answer

Solange Magnano

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Question

What does Katie Price compare her body to?

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Answer

A car

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Question

Which of the following surgical procedures is for health and cosmetic purposes?

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Answer

Rhinoplasty

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