The Importance of an American Institution
One institution that played a very important part in the advancement and betterment of plastic surgery, and of surgery in general, was Johns Hopkins. It was there that Dr. William Stewart Halsted created the first general surgery training program in the United States. In 1904 he published “The Training of a Surgeon”, which laid the foundation for what was to become the prototype for all modern surgical training programs. With this the U.S. could finally claim a level of surgical sophistication on par with Europe. It wasn’t long before the U.S. began to surpass the rest of the world, especially when it came to the subject of specialization within the field of surgery.
Johns Hopkins was also home to Dr. John Staige Davis, who was considered by most to be the first American to dedicate his practice solely to plastic surgery. He spent many years of his life working to establish specialized divisions within the practice of plastic surgery, and in 1916 he contributed a landmark paper to Journal of the American Medical Association which described the role of plastic surgery within the medical establishment, again emphasizing the importance of specialization within the field.
The 1940s and 50s
In 1946, the time had clearly come for the publishing of a scientific journal targeted specifically for plastic surgeons. In July of that year, the first issue of the Journal of Plastic and Reconstructive Surgery became a reality. Since then, the journal has continually served as a forum for the dissemination of knowledge and important discoveries among plastic surgeons and their medical colleagues, all aimed at providing benefit to patients.
With board certification in place and the birth of plastic surgery’s own medical journal, plastic surgery became fully integrated into the medical establishment by 1950, where it began to make its move into the consciousness of the public. Out of the field hospitals of the Korean War came even more advances in reconstructive surgery, including internal wiring techniques to deal with facial fractures, and the use of rotation flaps to correct massive skin injuries and deformities.
Modern Plastic Surgery
The modern history of plastic surgery really started to take shape in the 1960s and the 1970s. Plastic surgeons were moving to the forefront of the medical establishment, including one plastic surgeon who was appointed Surgeon General in 1969, and another who won a Nobel Prize.
There were also many significant scientific developments during this time. Silicone was a newly created substance which was growing in popularity as a staple of certain plastic surgery procedures. Initially, it was used to treat skin imperfections. Then, in 1962, Dr. Thomas Cronin created and unveiled a new breast implant device which was made from silicone. Over the next decade or so, silicone implants were developed for use in just about every imaginable part of the face and body.
In the 1980s, plastic surgeons and plastic surgery advocates made a big push to expand public awareness and improve public perception of plastic surgery. This increase in both the quantity and quality of information available to consumers, together with the economic boom of the 1980s, began to make plastic surgery more accessible to mainstream America.
Growth continued through the 1990s, despite problems caused by health care reform which caused sharp decreases in reimbursement from insurance companies for reconstructive work. Many surgeons were forced to focus more on cosmetic work in order to stay in practice, and some decided to forego reconstructive surgery altogether.
Surprisingly, the growing controversy over silicone breast implants did not seem to be deterring an ever-growing number of patients from seeking cosmetic procedures. Then, in 1998, President Bill Clinton signed a bill which included a provision requiring insurance companies to cover the cost of post-mastectomy breast reconstruction surgery.
Plastic Surgery Today
In the 2000s, cosmetic surgery has enjoyed an explosion in popularity, and medical advances have made possible reconstructive feats that were once only a dream of what might one day be. In this age of accelerated communication, the internet and television have gotten in on the game, and we can now view just about any kind of plastic surgery procedure from the comfort of our own homes.
Currently, the most important trend in plastic surgery is a move toward less invasive procedures designed to stave off the visible signs of aging. In fact, the most popular procedures at this time entail the use of injectable substances, such as facial wrinkle fillers and, most notably, Botox. It is estimated that there are over 1.1 million botox injections administered in the U.S. every year, and that number is steadily growing.
Even among plastic surgeons themselves, there has been a considerable ethical debate afoot concerning the advent of “Plastic Surgery Reality TV” The television show “Extreme Makeover”, while popular, has been the subject of some controversy. How much is too much, and what sort of values are we teaching through programming like this?
Of course, several other shows with plastic surgery themes have followed in the footsteps of "Extreme Makeover". Despite the ongoing debates about their merits, there is no doubt that people are thinking and talking about plastic surgery more than ever before in its history. We are all better educated as consumers about the potential risks and rewards of plastic surgery, and the stigma that was once attached to cosmetic surgery is falling by the wayside.
