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Plastic surgery the Past and the Future

 Already in the ancient times it was considered to be important for the people to get rid of their physical defects with surgical solutions. But even then – until the 19th mid-century – there were very primitive devices and methods available.
Let’s see how the modern aesthetic surgery evolved from the ancient methods.


History of plastic surgery


In the ancient Egypt people dealt with rudimentary interventions, but particularly it was a privilege for the Pharaohs and the upper crust. However these methods have been launched significant developments only 2600 years ago in India, where mutilated criminals were undergone reconstructive surgeries.

The anaesthesia and antiseptic techniques made the major surgical interventions to be available only in the 19th century, and in the 20th century the aesthetic surgery, breasts augmentation and silicone implants came into prominence.

Egypt, 4000 years ago


f__ra___maszk.jpgMany people believe that plastic surgery is relatively new, but the origin of the surgically repaired physical distortions dates back to 4000 years.

According to the so-called Edwin Smith surgical papyrus which contains medical records, around 1600 BC there were nasal bones and jaw joint rescuing primitive “plastic surgeries”.

In Egypt the good-looking appearance played an important role, it reveals the Pharaohs’ death masks.
The need for reconstruction of damaged skin evoked the plastic surgery, but then they were limited to superficial damages because of the lack of anaesthesia, emerging pain and strict religious rules.


Aesthetic interventions up to the Middle Ages


The next steps of the aesthetic procedures’ development linked with North-India where Susruta doctor healed the nasal injuries which were acquired during the fight with plastic surgery instead of mutilation.
Frequently occurred that the forehead skin was used to reconstruct the damaged nose or earlobe in case if criminals.

In 600 BC the surgeon’s encyclopaedia known as “Sushruta Samhita” described detailed the techniques of reconstructive interventions, the different diagnoses and therapies.


In the Roman Empire Aulus Cornelius Celsus doctor described in his work the reconstructive techniques of mutilated ear, nose and lips, which were similar to the common practice in India.
According to legends in AD 700 Byzantine emperor Justinian II after his dethronement his mutilated nose was successfully operated that he could come into power again.

In the Middle Ages the situation was not favourable for the development of reconstructive surgery, what’s more in the 13th century Pope Innocent III. referred to the Catholic canon and abolished all sorts of surgery.

The age of revival – Renaissance


v__nusz_sz__let__se2.gifUp to the 15th century no progress was occurred in the processes of plastic surgery. In the age of Renaissance the book of Indian Susruta became to be widely known.
The surgical for example suture techniques became to be more refined, the interventions were made by minimal cutting, and according to records the Sicilian Branca family carried out successfully plastic surgeries on ears and lips.


One of the most famous pioneers of plastic surgery was Gaspare Tagliacozzi in the 16th century in Bologna who dealt with skin graft as well and he carried out a nasal plastic surgery with a skin taking out from the patient’s arm.
For lack of enthusiastic followers the cosmetic surgery fell into oblivion until the 19th century.


The first successful skin graft


In London in October of 1794 a popular magazine released the ancient Indian method, therefore the processes could widely spread. The rudimentary introduction of the anaesthesia and the prevention of infections linked to Johann Friedrich Dieffenbach, and therefore the risk factors were greatly reduced.


By the end of the 19th century the aesthetic surgery had become increasingly important. A British surgeon, Astley Cooper implemented the first successful skin graft in 1817 during an amputation of a thumb.


The first American aesthetic intervention (reconstruction of a cleft palate) was carried out in 1827 by John Peter Mettauer with his self-designed devices.


The plastic comes from the Greek “plastikos” which means shaping, forming. In the 19th century Carl Ferdinand von Graefe named for the medical process “plastic surgery”.

Care of war injuries


In the World War I. amputation was the only chance for casualties to stay alive. Development of anaesthesia and antiseptic techniques blazed a trail for plastic surgery widely.
The application of modern interventions link two doctors. Harold Gillis focused on facial reconstructive surgery, since in that era because of the social expectations the casualties had to wear masks during their whole life. His former student and cousin, Archibald McIndoe helped the burn injuries of Royal Air Force.

The “modern” plastic surgery


Aesthetic and reconstructive surgeries have crucial different that healthy people undergoes aesthetic surgery to improve their appearance.


Silicone was the first


elso_mutet.jpgThe aesthetic surgery was dated from the year of 1962, from the first breast implantation.

The first recorded breast augmentation was carried out by an Austrian doctor, Robert Gersuny, who worked with the paraffin-injection technique developed in the 1890s. In the 1930s there was a widespread used process that from the patients’ buttocks excised adipose tissues were implanted to breasts, but due to its failure this process went out of fashion in the 1940s.


Breast augmentation made with silicone injections spread during the World War II. in Japan among the prostitutes who tendered to American soldiers, afterwards it could spread in the USA.

Breast implants from wool and ivory


As a result in the 1950s in the USA besides the silicone injections other methods had appeared: other synthetic materials such as polyvinyl, nylon, polyurethane, even also Teflon, but implants were made of glass, ivory balls, wool and cartilage as well.


There was a great breakthrough in 1961 when Thomas Cronin and Frank Gerow developed a new type of implants. The Dow Corning Company launched a new product which was a special silicone bag filled with an appropriate quantity of silicone gel. Today the sterile saline filled implant is the most widely used product besides the silicone implant, and its first application linked the French H.G. Arion and it has already used from 1965.


In spite of the initial reluctance these products dominated on the breast implant market of the USA in the 1990s. From 1992 the commissioner of the American Food and Drug Administration (FDA) called the implant manufacturers for a voluntary moratorium on these products. Because during this time they couldn’t confirm the safety of the products, the American health authorities banned the promotion of silicone implants.
The ban lasted only for 3 months, because there was no evidence of the silicone implant’s deleterious effect found.


The development of breast implants


The silicone implants have undergone important developments in the last 40 years.


In the 1960s the first generation of the breast implant was developed by two doctors in Houston, Thomas Cronin and Frank Gerow. It was a 0,25 mm thick silicone bag filled with dense, viscous silicone gel, looked like a teardrop.


In the 1970s its “husk” was thinner (only 13 mm) and the gel was much more fluid. However, numbers of legal proceedings were instituted against the manufacturer, because in many cases the implants torn.


Also in the 70s spread the “double implant” which means that the saline implant contains a silicone implant inside.

In the 1980s, after many improvements, the implants were made in compliance with strict standards for manufacturers: they were made of much stronger material; the gel became much more elastic and denser to prevent to be damaged. Appeared the round and cone shape implants.


In the mid 90s in Europe widely spread implants were cohesive, flexible and filled with elastic and less stable gel to reduce the risk of damage and displacement.



Click here to get to know more about the new generation of breast implants.


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