While beliefs and perceptions about cosmetic surgery have generally been mixed, the arrival of the new millennium set off a change in how people think about it.

Part of the reason for this change may have to do with a misconception many people had about the term “plastic surgery.” Many people viewed the term in a negative manner because they misconstrued the word “plastic” to mean fake or artificial. The term in fact derives from the ancient Greek word “plastikos”, meaning, “to mould” or give form.

Plastic or cosmetic surgery didn’t always have making the human body more symmetrical or aesthetically pleasing  as its main focus. In the beginning, its goal was to help people correct physical deformities they were either born with or sustained as a result of war.

Throughout the years cosmetic surgery has changed from being predominately about correcting anatomical deformities to focusing more on the physical aspects of beauty and making the face and the body pleasing to the eye.

In the Very Beginning

According to the American Society of Plastic Surgeons, as far back as 4,000 years ago, documented evidence exists of medical treatments for facial injuries. In 800 B.C., Indian physicians also performed reconstructive procedures with skin grafts.

The first plastic surgeon was an American doctor by the name of John Peter Mettauer. His first cosmetic operation was a cleft palate procedure in 1827. What’s amazing about this particular procedure was that the instruments he used were handcrafted by himself.

In the Late 1800s and Early 1900s

War was the primary influence behind numerous developments in cosmetic surgery from the end of the 1800s through the beginning of the 1900s. In fact, shortly after World War I, with huge numbers of soldiers needing reconstruction, people began to realise how valuable cosmetic surgery could be. Surgeons had never before seen so many extensive head and facial injuries.

During this time aesthetic procedures advanced, and surgeons started to realise how their services could help people plagued with physical abnormalities or deformities.
Nineteenth century American Plastic surgeon John Orlando Roe summed it up well:

“How much valuable talent (had) been…buried from human eyes, lost to the world and society by reason of embarrassment…caused by the conscious, or in some cases, unconscious influence of some physical infirmity or deformity or unsightly blemish.”

The 1940s

During the 1940s, many surgeons served their country in the Second World War, performing cosmetic surgery procedures on wounded soldiers, aviators and sailors.

In 1948, the original founder of ASPS, Dr Jacques Maliniac, went on to form the Educational Foundation of ASPS, which is currently known as the Plastic Surgery Foundation or PSF. Maliniac also served as its President until 1955.

The Foundation’s main goal was to provide supportive research regarding acquired and congenital deformities. As well as promoting high standards of practice, research and training in cosmetic surgery, it also offered scholarships and prizes, promoted lectures and held seminars and meetings to educate the public about cosmetic surgery.

In the 1950s

Having board certification and its own scientific journal, cosmetic surgery was finally inducted into the American medical establishment by 1950.

Enhanced communications with the general population initiated by ASPS President Leon Sutton set off a chain of events. To start with, President Harry Truman put forward a national healthcare plan. Plastic surgeons also began appearing on televisions throughout America.

Just as in other areas of science and medicine, discoveries and innovations in cosmetic surgery were evolving. A few of these innovations to hit the industry included internal wiring for facial fractures and rotation flaps, which helped correct skin deformities.

In the 1960s

In the beginning of the 1960s, cosmetic surgery in America was becoming even more publically visible. This was due in part to an increase in the number of procedures being performed by surgeons.

Many scientific developments came to light during the 1960s. Silicone, for example, began to emerge as a multifunctional substance that surgeons could use to not only treat skin imperfections, but also enhance breast size.

In the 1970s

During the 1970’s surgeons moved to the forefront of the medical profession. What fascinated many people was that plastic surgeons possessed skills that no one else did, skills that could benefit the human body as a whole.

In the 1980s

Informing patients was the big movement during the 1980s. Surgeons worked hard to bring their knowledge and expertise to the people. Studies during this time indicated that patients were interested in learning more about cosmetic surgery in the comfort of their own homes. Therefore, surgeons and associations produced pamphlets to educate patients about individual and specialty procedures.

In the 1990s

The 1990s began on a high note with continued discoveries and innovations in the cosmetic surgery field.

During this decade the cosmetic surgery profession suffered a sort of identity crisis, mostly because consumers failed to see the broad body of work surgeons performed. A survey conducted by ASPS in the early 1990s revealed that Americans didn’t realise that cosmetic plastic surgeons also performed reconstructive work. Most people thought cosmetic surgeons only specialised in cosmetic surgery.

In the USA in January of 1992, the FDA called for a temporary moratorium on the use of silicone gel breast implants. A few months later the agency announced that silicone implants would only be made available to women for reconstructive purposes and would be monitored with clinical studies.

Regardless of countless government-funded studies published in scientific journals, enumerable studies carried out by the prestigious Institute of Medicine, and a report released from the federal court-appointed National Science Panel in late 1998, all studies had the same conclusion: There was no correlation between illness in women and breast implants. This influenced the decision to create a revised settlement.

In the 2000s

The new millennium has seen rapid growth and changes in the cosmetic surgery field.

Important Events that Occurred During the New Millennium:

• Immediately following the approval of anti-wrinkle toxin injections by the FDA in 2002, ASPS surgeons performed an average of 1.1 million injections each year through 2006.
• In 2003, close to 9 million cosmetic procedures were performed in the USA, 32 percent more than in 2002. In the same period, ASPS surgeons performed 64 percent more injectable treatments.
• By 2004, close to 15 million cosmetic surgery procedures had been performed in the United States. By 2006, the number had increased to 16.2 million.

In November of 2006, a decade and a half after the start of the moratorium on silicone implants, the USA’s FDA approved the return of silicone implants for use by the general population. In addition, in 1999, the FDA called for a safety and effectiveness review on saline implants.

One of the innovative trends currently in the field of cosmetic science is the ability to reduce scarring from surgery and reduce patient recovery time. Surgeons are also devising new methods with supporting data to show people the “quality of life improvements” cosmetic surgery is capable of delivering through its wide array of procedures.

Typically reserved for the rich and famous, cosmetic surgery was, and still is, desired by many women and men, regardless of financial constraints. In today’s world with numerous financing options available, it becomes just a matter of “what you would like to do first?”