While the sub specialty 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 the time periods of development for both Plastic Surgery and plastic materials are similar, there is no direct link between the two. It was not given its name because it used plastic materials in surgery. The Greek word, ‘plastikos’, whicih means to mold, shape, or give form to is the meaning behind the naming of the medical specialty Plastic Surgery. 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. Plastic Surgery organized itself into a formal society in 1931 with the formation of the American Society of Plastic and Reconstructive Surgery, recently condensed to 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 this 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 Surgery and plastic materials share yet another similarity…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.