When one thinks of Plastic surgery in other countries, the United States springs immediately to mind as that is where Plastic and Cosmetic Surgery has known its greatest boom and has had its most amazing development.
The 1920s and 1930s saw the formation of numerous professional and academic societies pertaining to the field. In 1921, the American Association of Oral and Plastic Surgeons, the precursor to the American Association of Plastic Surgeons, was formed. Legend has it that Dr Dunning from New York, Dr Brophy and Dr Moorehead from Chicago met at the Chicago Athletic Club in order to organise it. In 1937, the American Board of Plastic Surgery was established, thus creating a standard of excellence for the field. This was the first official association of Plastic and Cosmetic Surgery in The United States. This was a time in the U.S. which was full of contradictions as it coincided with great prosperity and conservatism – the very first Miss America was elected in Atlanta City on 7th September 1921.
During these prosperous years, the Americans were beginning to live well and for the first time immigration was greatly cut down. Up until the 1929 Wall Street Financial Crash, the right to beauty had been defined as a democratic right. Women’s magazines and the beauty retail business were very successful and Cosmetic Surgery got off to a cracking start.
In the 30’s, the members of the newly founded institution the ASPRS, the American Society of Plastic and Reconstructive Surgeons, which was created in 1931, met regularly in New York at Dr Maliniac’s office. (Since 1999, the ASPRS has become the American Society of Plastic Surgeons: ASPS). One of the main concerns of Plastic Surgeons was the fact that the specialty, while growing rapidly, was not yet recognized by the American Board of Surgeons, the medical certifying organization of the time. The members were board-certified in other related specialties, and so they convinced the American Board of Surgery to establish an American Board of Plastic Surgery. Physicians were required to pass an exam to qualify as Plastic Surgeons, and in 1941 the ABPS came under the jurisdiction of the American Board of Medical Specialties (the only official entity overseeing physician certification in the United States). In other words, this was the start of Cosmetic and Plastic Surgery as a proper surgical speciality.
ASPRS grew steadily and in 1948 the Educational Foundation of ASPS, now known as the Plastic Surgery Educational Foundation, PSEF, was formed. To this day this Foundation helps train and teaches future Plastic Surgeons.
In the Fifties, Plastic Surgery appeared on television for the first time. The Korean War brought fantastic new progress in reconstructive surgery and the Sixties produced great advancements particularly with the discovery of a new substance: silicone. In 1962 Doctor Thomas Cronin unveiled his utilisation of silicone in Breast Implants. At the end of this decade, in 1969, a fellow Plastic Surgeon, Dr Jennings, member of the ASPRS, was appointed Surgeon General of the United States by President Nixon, the first and only Plastic Surgeon to date to achieve this public service honour.
In the Seventies Plastic Surgery was once more at the forefront with a Nobel Prize given to the ASPRS member Dr. Joseph Murray. Another ASPS member, Dr. G. Crikelair developed flame-retardant children's clothing, saving thousands of lives, and thousands more from agonizing pain and disfigurement. At the same time, the Federal Trade Commission became difficult with the Society and its practices and wished to control how the Surgeons gained their qualification. Eventually after a long battle they backed down.
At the dawn of the 21st Century, over 5000 doctors are certified Plastic Surgeons by the American Board of Plastic Surgery, of which 97% belong to the ASPS. The District of Columbia (179 km², 559 000 inhabitants, where Washington D.C. is located) has the greatest number of Plastic Surgeons per capita: 1 for every 31,942 whilst Iowa has 1 for every 163,339! (1994 ASPRS statistics).
Again in 1994, in the U.S. liposuction remained the most popular Cosmetic Surgery with 31% of all carried out operations. It was performed 51,072 times, 47% were 35 – 50 year olds and 87% were women.
Simultaneously to the forming of the Society, a number of prestigious institutions became internationally renowned as Plastic Surgery centres, such as the Mayo Clinic in Rochester, Minnesota. This establishment which is truly dedicated to medicine, surgery and education was founded in 1907 by two doctors whose father, an English doctor, had come to Rochester in 1863 during the American Civil War. His two sons, known as the Mayo brothers, founded the Mayo Clinic in 1907 which was quickly at the forefront of technology with lifts, X-Rays, and the first fax machine. As from 1915 The Mayo Graduate School of Medicine gained the reputation of being one of the best medical schools in the world.
Nowadays, the Clinic exists under its name in various other States, and gives two year supplementary teaching in Plastic Surgery which is very sought after by Doctors from all over world. The selection criteria remain very select and strict: education, recommendations, and motivation are part of this selection.
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In other countries outside the USA, Plastic Surgery has also seen important developments
Professor Ivo Pitanguy remains one of the most outstanding personalities in this profession. Brazilian, covered in diplomas, qualifications and honours, his surgical techniques are taught all over the world. As member of the Brazilian Society of Plastic, Cosmetic and Reconstructive Surgery he has given his country and this speciality a world class reputation.
Following the progress made in Plastic and Reconstructive surgery after the two World Wars, and conscience that this speciality was making great progress, in 1955 in Uppsala, Sweden, a number of Plastic Surgeons from various countries joined forces in order to exchange information and formed a Society that is today the International Confederation for Plastic, Reconstructive and Aesthetic Surgery – IPRAS. 78 international Societies are represented and there is a 4 year revolving Presidency.
What remains unbelievable is that France, which was one of the pioneers in Aesthetic Surgery, is very poorly represented in these international organisations. It is not part of the Executive Committee of the International Confederation (IPRAS) whilst Germany, Finland and Hungary all are members. Its Secretary General is a Spanish Plastic Surgeon, member of the Sociedad Española de Cirugia Plastica, Reparadora y Estética (SECPRE).
Whether it be the Australian Society of Plastic Surgeons (Australia), la SECPRE (Spain), la Nederlandse Vereniging voor Plastie Chirurgie (the Netherlands), l'Instituto de Chirugia Plastica Craniofacial (Brazil) or any of the other multiple American Societies, all without exception have a link to the Internet.
Plastic Surgeons place their internet addresses on line and are easily accessible. All the latest information on the most up-to-date techniques in Plastic Surgery is posted on the websites, and you can read their Newsletters and have access to the information that is necessary to the patients. All the operations are explained, each case is examined and one can also directly ask questions. According to the patient’s location, this site will propose the closest Plastic Surgeons and give the insurance information of each.
The French Plastic Surgery Societies (SOFCEP, SFCPRE) are on the website and the French Plastic Surgeons are slowly beginning to open websites now that the Conseil National de l’Ordre des Médecins has given its approval, on the condition that the rules of deontology be respected.