Plastic surgery history Plastic surgeons




The face is the mirror of the soul and our cover letter. Express our emotions and it is very difficult to hide any defect or imperfection in it. Plastic surgery Facial tries to improve the external appearance, correct the functional defects and reconstruct the deformities of the face. The name derives from the Greek term girurquiki, which means surgery or hand and plastikos, which means to mold. Exists proof of its existence for 3,500 years. Nowadays there are primitive peoples who perform surgical procedures aimed at body embellishment. So, we find, both in Africa and in the Amazon rainforest, indigenous communities that practice increase of the lower lip, by introducing a clay or wooden plate (figure 1), the extension of the lobe of the ear (figure 2), skin scarifications (figure 3), etc. The perforations of the nose, ears, etc., have a high ornamental and aesthetic load in our days. The concern for aesthetics goes back to ancient Egypt, where the first reference to some technique appears surgical, in the 3,500-year-old Ebers papyrus, although it is in Smith’s papyrus (translated by Edwin Smith in 1862) 1,2 (figure 4), in which some 48 are described cases intervened, mentioning procedures surgical procedures to treat, above all, nasal fractures, skin sutures, blockages with linen, wooden splints and very precise anatomical descriptions.  In another very remote area, in India, a development takes place very important medicine and surgery and that is known as an Indian period. This stage is situated around the year 1,500 a.C. and their knowledge and contributions are collected in several Vedic books (the Rig-Veda, the Atharva-Veda). In them describe, among other procedures, the reconstructive techniques of the nasal pyramid, since amputations of the nose were frequent as a punishment to various crimes2, 3. The Sushruta-Samitha collects the works of Sushruta, a doctor of Benares, who, in the sixth century BC describes the use of several flaps such as cheek or nasofrontal (Figures 5 and 6) for nasal and auricular reconstruction. These procedures were performed by Koomas or potters. Such knowledge spread through Persia, Egypt, Greece and, finally, Rome, thanks to the invasion of India by Alejandro Magno1, 2, 3, 4. In Greece only Hippocrates refers to some reconstructive treatments, although there are other doctors such as Paulus Aegineta (625-690 BC) who describe in texts of the time surgical procedures to solve aesthetic problems. But it is in Rome where Aulus Cornelius Celsus, in the si – glo I d. C., collects the existing knowledge until then, from the Hindus, Egyptians, Persians and Greeks. It is in his book De Re Medica where he describes techniques of plastic surgery proper, such as the flaps of advance (figure 7). That’s why Celsus is considered the authentic precursor of reconstructive surgery2, 5. Galen, in the 2nd century AD C., also used them, because in his writings repair techniques of the face are mentioned by the realization of neighborhood flaps. The Byzantine doctor Orbasio collects these reconstructions in his medical encyclopedia. During the Middle Ages, coinciding with the fall of the Roman Empire and the expansion by Europe of the barbarian peoples from the north and Central Asia, the practical disappearance of these surgical techniques in particular, and of medicine and surgery in general, since expressly prohibited, in the thirteenth century, the realization of these procedures2, 3. At this time, only Arab medicine maintains a considerable scientific level and cauterizations and sutures were developed. They highlighted the contributions of Avicena and Averroes and, although we do not have many medical treaties of those years, the nasal reconstruction is collected he practiced Emperor Justinian II (Rhinotmetos) using a frontal flap. The doctor deserves a special mention Cordovan Abulcasis (eleventh century) who, in his work al-Tasrif, collected and improved the surgical techniques described by the ancient masters Hippocrates and Paulus Aegineta, among others6. During the Middle Ages we only find a clear reference of nasal reconstruction, collected in the work of Lanfranco in 1295. In this period of history the knowledge Surgical patients did not experience any progress. However, the Renaissance was the resurgence of surgery. So we see how already in 1414 in Bologna, Hugo de Locca emphasizes the basic principles of healing, being his son Teodorico who describes the careful cleaning of the wounds using compresses soaked in wine. Since syphilis and leprosy proliferate in the Renaissance, it is necessary to resume the reconstructive techniques