The history of plastic surgery, from antiquity to the present day

The key milestones

Period	Milestone
Ancient India	The treatise of Sushruta describes reconstruction of the nose with a flap of skin from the forehead
1st century	Celsus describes repairs of the ears, lips and nose in De Medicina
1597	Tagliacozzi publishes in Venice his method of reconstructing the nose with a flap from the arm
1794	The “Indian method” is described in London and adopted in Europe
1846	First public general anaesthesia with ether, in Boston
1867	Lister publishes his work on antisepsis
1914-1918	Soldiers with facial wounds (“gueules cassées”): the birth of modern reconstructive surgery
1920-1930	Suzanne Noël and the pioneers of cosmetic surgery in France
1962	First silicone gel breast implant (Cronin and Gerow)
1990	Joseph Murray, a plastic surgeon, receives the Nobel Prize in Medicine for the first kidney transplant
2002	In France, the law of 4 March 2002 regulates cosmetic surgery
2005	First partial face transplant, in Amiens

In antiquity: reconstructing the nose

The earliest texts on plastic surgery come from ancient India. The treatise attributed to Sushruta describes the reconstruction of an amputated nose — amputation of the nose was then a punishment — using a flap of skin taken from the forehead and folded down onto the nose. The principle of this forehead flap is still used in reconstructive surgery today.

In the Graeco-Roman world, Celsus described methods of repairing the ears, lips and nose in De Medicina in the 1st century. In the 4th century, Oribasius, a Byzantine physician, devoted several passages of his medical encyclopaedia to repairs of the face.

From the Middle Ages to the Renaissance

In the Middle Ages, surgery made little progress in the West; the lack of hygiene and anaesthesia limited operations. During the Renaissance, the Italian surgeon Gaspare Tagliacozzi published in 1597 a method of reconstructing the nose with a flap of skin from the arm: the arm was held against the face for several weeks, until the flap had taken. His method then fell into oblivion for almost two centuries.

The 19th century: the word “plastic”, anaesthesia and antisepsis

At the end of the 18th century, the description of the “Indian method” of nose reconstruction, published in London in 1794, revived these techniques in Europe. In the 19th century, German surgeons began to use the term “plastic” surgery, from the Greek plastikos, “that which shapes”: it does not refer to plastic as a material, but to the art of moulding tissues.

Two discoveries changed everything: general anaesthesia with ether, demonstrated in public in Boston in 1846, then antisepsis, described by Joseph Lister in 1867. Operations could now be longer, more precise and less often complicated by infection.

1914-1918: the “gueules cassées” and the birth of reconstructive surgery

The First World War caused facial injuries of a severity and in numbers never seen before. In France, Hippolyte Morestin, at the Val-de-Grâce military hospital, and in England, Harold Gillies, developed techniques for reconstructing the face with grafts and flaps, in several operative stages. The soldiers with facial wounds, nicknamed the “gueules cassées”, founded a mutual aid association in 1921 that still exists. Reconstructive surgery became a discipline in its own right.

Between the wars: the beginnings of cosmetic surgery

The techniques developed for the wounded were also used to correct physical flaws or the signs of ageing. In France, Suzanne Noël, one of the first women surgeons to devote herself to cosmetic surgery, defended its social role in a book published in 1926. For a long time, however, cosmetic surgery was viewed with suspicion by part of the medical world.

After 1945: a specialty in its own right

After the Second World War, plastic surgery became organised as a specialty, with its own professional societies, journals and training. In 1962, the first silicone gel breast implant opened the modern era of breast augmentation (history of breast implants). Microsurgery then made it possible to transfer tissue together with its blood vessels, to reconstruct a breast or part of the face. In 1990, Joseph Murray, an American plastic surgeon, received the Nobel Prize in Medicine for the first successful kidney transplant.

In 2005, in Amiens, a French team performed the world’s first partial face transplant.

In France, surgery regulated by law

In France, cosmetic surgery is regulated by the law of 4 March 2002 and its decrees of 2005: the facilities where it is performed must be authorised, the patient receives full information and a detailed written quote, and a 15-day cooling-off period must be observed before the operation. The plastic surgeon is the only surgeon qualified in plastic, reconstructive and aesthetic surgery for the whole body.

And today?

Plastic surgery is divided between reconstructive surgery (after cancer, an accident or a malformation) and cosmetic surgery, to which less invasive procedures such as injections are added. In 2025, plastic surgeons performed more than 35 million cosmetic procedures worldwide, according to the ISAPS survey (the countries where cosmetic surgery is most practised).

Frequently asked questions

References

• Glicenstein J. History of augmentation mammaplasty. Ann Chir Plast Esthet 50: 337-349, 2005.
• French Public Health Code, articles L.6322-1 to L.6322-3 (cosmetic surgery).