Cosmetic surgery began to be practiced in the last part of the nineteenth century as surgical intervention became increasingly possible because of the development of anesthesia and sterile techniques. One of the first cases to be reported in the last part of the nineteenth century had to do with correcting what was known as saddle nose, a deep depression in the middle of the nose. There are several causes of this condition, but one of them was syphilis. This association with syphilis made those with such noses particularly willing to try to get some surgical change. Large noses were also an issue and intranasal rhinoplasty (hiding the incisions inside the nose) was first done in the 1880s.
Plastic Surgery Out of the Closet
Public knowledge of the possibility of plastic surgery came during World War I (1914-1918) as surgeons treated patients in unprecedented number with bad facial and other visible scars. The “miracles” wrought by the surgeons brought plastic surgery out of the closet, and there were enough physicians engaged in it to found the American Association of Oral Surgeons in 1921, later called the American Association of Oral and Plastic Surgeons, and still later, the American Association of Plastic Surgeons.
The Rise of the Beauty Surgeon
These early-organized plastic surgeons were cautious about their reconstructive surgery, determined to use their skills to help the maimed but not to do frivolous surgery designed to make people more “beautiful.” Not all would-be surgeons agreed with them, and a separate group popularly called “beauty surgeons” developed. These surgeons were looked down upon for their promises to improve the looks of their patients. They took shortcuts, avoiding some of the time-consuming operations involving bone and cartilage grafts. Instead, they relied upon the injection of paraffin, which for a time in the 1920s, was seen as a panacea for all soft-tissue defects. It was widely used to fill facial wrinkles. Unfortunately paraffin had a tendency to migrate to other areas, particularly if the patient spent time in the sun. That tended to disfigure the patient, who then had to go through the process again. One of the best known of these beauty surgeons was Charles C. Miller of Chicago, who wrote an early textbook entitled Cosmetic Surgery: The Correction of Featural Imperfections.