While the subspecialty of medicine known as Plastic Surgery
(one of the 22 recognized specialties of medicine) is now
so incredibly common, there are few who would not know what
it is. But yet, I will occasionally get asked this question
by a new patient during our consultation...'now tell me
where the plastic goes'...or...'will the plastic used in
the operation get infected?' Indicating that some still
believe that the name 'plastic' in Plastic Surgery relates
to a material and that plastic surgery operations involve
putting in plastic materials.
While plastic surgery as a medical specialty and synthetic
plastic materials share incredibly similar time periods in
development, there is no direct correlation between the
two. Plastic Surgery was not given its name because it used
plastic materials in surgery. The word, 'plastic', as used
in Plastic Surgery comes from the Greek word, 'plastikos',
meaning to mold, shape, or give form. And this is certainly
an accurate description of what Plastic Surgeons do...cut,
shape, and mold tissues to give human body parts
recognizeable forms whether it be for reconstructive
purposes or for cosmetic alterations. As a medical
specialty, Plastic Surgery became an organized body in 1931
with the formation of the American Society of Plastic and
Reconstructive Surgeons (now known as the American Society
of Plastic Surgeons). It's first formal training program
began several years earlier in 1924 with the establishment
of the first plastic surgery residency at Johns Hopkins in
Baltimore. Formal board-certification in Plastic Surgery
started in 1937 which dramatically raised the standards for
the specialty.
Plastic materials developed right around the same time
frame as Plastic Surgery. The earliest true thermosetting
plastics had their beginning in the late 1800s with the
commerically successful product known as Bakelite
introduced in Britain in the early 1900s. But DuPont with
its polyamide (nylon 66) plastic in the 1930s popularized
the material here in the United States. New plastics
followed quickly such as polystyrene and polymethyl
methacrylate. (acrylic). All these plastic materials become
tremendously popular and necessary during World War II as
components of many military products such as aircraft
canopies and radar units. And here is where plastic
materials share another similarity to Plastic
Surgery...their development was propelled by wars, WWI and
WWII. Military conflicts and the need for personal
protection (plastic materials) and in the treatment of
their war-related injuries (Plastic Surgery) served as a
catalyst for both of their developments.
A final sidenote of both of their pre-WWII history is that
they similarly converged to deal with a growing problem in
the 1930s...motor vehicle accidents. As cars became more
common, so did auto accidents and injuries from the
shattering of glass windshields. Most commonly, severe
facial lacerations resulted from windshields at the time.
Plastic surgeons expressed concern about this problem and
manufacturers, such as DuPont, were spurned on by these
efforts to develop shatterproof windshields. As Plastic
Surgery performs many huundreds of different operations
from the face and throughout the body, very few have ever
actually required plastic materials to make the operation
successful. While breast and facial implants, which are
very common and popular cosmetic operations today do use
synthetic materials, they are a silicone-based rubber
material. Technically, not a plastic material in the
organic chemistry sense. Only one operation in all of
Plastic Surgery has ever really used a plastic material and
that is an acrylic cranioplasty where a section of the
skull is replaced by a 'plastic piece'. While not as
commonly done today, acrylic cranioplasties are still done
by some Plastic Surgeons and neurosurgeons as well.
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Dr Barry Eppley is a board-certified plastic surgeon in
private practice at Clarian Health in Indianapolis,
Indiana. He writes a daily blog on trends in plastic
surgery at http://www.exploreplasticsurgery.com
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