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… that plastic surgery has been around for thousands of years? It may be increasingly in the news today due to its popularity, variety and sometimes, cautionary tales (eg Jocelyn Wildenstein, Joan Rivers, Michael Jackson, Carrot Top and many, many others), but plastic surgery procedures have been documented to exist as early as 600 BC!

Perhaps not surprisingly given the ubiquity of nose jobs today, the first documented cosmetic surgical procedures are rhinoplasties. Descriptions of rhinoplasties have been found in ancient Hindu texts written 2,600 years ago. These early procedures, involving skin grafts from a cheek or forehead, were born of necessity, however - dire necessity. Facial mutilation, particularly the amputation of the nose, was a punishment frequently doled out by vicious bands of marauders traveling throughout India. The Hindu justice system also spurred the necessity for reconstructive surgery by levying the same harsh and humiliating punishment on adulterous wives. Yikes!

Plastic surgery in ancient times was not always due to necessity, however. The Roman ritual of the daily public bath can be held responsible for several surgical procedures developed purely for cosmetic purposes. Popular among them, especially among freed slaves, was the removal of telltale brandings and whip marks. The removal of battle scars on the back, considered marks of cowardice, was also in demand. Another procedure made popular by public bathing was male breast reductions. In his text, De Medicina, written in 30 AD, the doctor Cornelius Celsus describes a procedure to reduce the large, shameful breasts of an obese man. So cosmetic surgery performed on men is not a recent phenomenon after all.

Like today, plastic surgery has also long been used as a tool for career advancement. Holy Roman Emperor, Justinian II, relied on a nose job to engineer a spectacular career move. At the end of the 7th century AD, an amputated nose stood between the deposed Justinian and his lost throne. Known as the Rhinometus or “one with a slit nose,” Justinian was overthrown and his nose mutilated so that his disfigured appearance would prohibit him from regaining his throne. These efforts proved futile, however, as he underwent nasal reconstruction and subsequently returned to power.

Career considerations, in fact, proved instrumental in the development of both, face lifts and breast enlargements. Famed actress, Sarah Bernhardt, is said to have received one of the first surgical face lifts almost a century ago at the hands of French doctor, Suzanne Noël (pictured above). Her refreshed look was duly noted when she returned to the stage after a holiday. Dr. Noël’s 1926 textbook describing her techniques and procedures and including before and after photos, contributed to the acceptance of plastic surgery in modern times. As the first female plastic surgeon, Dr. Noel was a trailblazer in other ways too.

Several years before Dr. Noël picked up a scalpel, a 41-year old singer had the first surgical breast augmentation. She had had a growth removed in 1893 in Germany. Her doctor had decided that given his patient’s profession, it wouldn’t do for her to have uneven-looking breasts. So, he harvested fat from her back and transplanted it into her breast, providing her with evenly sized breasts.

Fat injections continued to be used to enlarge breasts until the 1920s. By then, unfortunatley for their patients, surgeons had been experimenting with a wide variety of materials to increase breast size. Using implants made of ivory, glass, ground rubber, peanut oil, honey and ox cartilage, it is no surprise that just as today, their removal made up almost as large a part of a surgeon’s practice as their insertion. Some things never change, especially man’s quest to improve his appearance, no?