Plastic surgery has written origins in ancient India in 600 BC (or earlier according to some accounts) and to some extent in ancient China. Some parts of this knowledge diffused to Europe probably via Arab merchants but this was kept as closely guarded family secrets. In the late 18th century knowledge of skin flaps was carried by British surgeons who had witnessed nose reconstruction performed in India by a vaid [medical practitioner]. This technique was called the Indian Rhinoplasty.
Carl Ferdinand Von Graef coined the term plastic surgery in Germany in 1818. The word plastic is derived from Greek word Plastikos, which means to mould or to reshape. Modern Plastic Surgery evolved as an organized discipline in the early 20th century mainly to treat difficult facial disfigurements caused by the two world wars. Much progress was made in the first 50 years of the 20th century. Later on it grew to address a wide variety of difficult problems in many areas of the body and became known as a problem solving specialty. The new wave of interest in cosmetic plastic surgery in the last 30 years brought great media attention to this specialty.
It has always been difficult to define the specialty as it is not specific to any area or disease. Plastic surgeons mostly deal with issues of ‘form and function’. The word plastic surgery comes from ‘plasticos’ – Greek for the ability to mould or change shape. Incidentally, it has nothing to do with plastic materials that we use in everyday life. By popular imagination and press coverage, plastic surgeons are identified with cosmetic surgery. However, it is important to recognize that plastic surgery has two major divisions: Reconstructive and Aesthetic [a.k.a cosmetic]. This division is not due to water-tight differences in technique but has more to do with the purpose served by the surgery. Reconstructive plastic surgery deals with problems caused by birth defects, disease, injury or other causes. Cosmetic [Aesthetic] plastic surgery deals with issues related to self-improvement of the person’s face or body i.e. not caused by a disease or injury. Thus correcting a nose deformed by injury or burn is reconstructive while improving the shape of an otherwise normal nose is cosmetic. But when the nose of a cleft patient is being improved, the sub-divisions get blurred.
Plastic surgeons are the primary treating specialists for conditions such as burn injuries, hand trauma, facial trauma, skin cancer and certain birth defects. Equally they are also involved in providing support to other doctors whose attempts at repair of body tissue have failed for whatever reason: for example a case of multiply recurrent pilonidal sinus or a multi recurrent hernia may require plastic surgical flap techniques to finally cure it. A non-healing exposed bone fracture may need a bone or soft tissue flap to finally effect healing. Thus the Plastic Surgeon, in addition to having great surgical skills and a good artistic sense, must also have accurate anatomical knowledge of all areas of the body and a wide surgical experience to be able to help in diverse problems. Most plastic surgeons train as general surgeons first and then specialize in plastic surgery.