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Much of it was trial and error and some referenced techniques pioneered in Ancient India by Sushruta. The tube pedicle skin graft, in which a flap of skin is separated, but not detached, and used to suture over an injured area, only being detached once blood supply is established, is probably Gillies` best-known development. In 1920 Gillies produced his magnum opus, "Plastic Surgery of the Face" based on his wartime experience. It is also worth pointing out that as many of the men required multiple operations, it was during this time that advancements in anesthesia techniques, using rubber tubing, also came about; many of which are still used today.
Plastic Surgeon Taimur Shoaib also reflects on surgery through the ages, "I have a special interest in rhinoplasty and I find the history of plastic surgery hugely relevant to this.
Plastic surgery started with rhinoplasty back in 600BC in India with what we now know as the forehead flap, described by Sushruta, for the reconstruction of injuries to the nose, usually because of a punishment. Criminals, back in those days, would have their noses chopped off (hence the origins of the phrase: "chop off your nose to spite your face") and Sushruta offered a form of reconstruction.
The technique was meticulously described in the medical tome that he authored. Rhinoplasty re-emerged as the subject of plastic surgery history in Rennaisance times. A surgeon called Gaspare Tagliacozzi described a way of reconstructing the nose with almost Heath Robinson complexity, using tissue from the inner aspect of the arm, which was still attached to the arm for a few weeks, and the arm was held in place using a perplexingly complicated plaster of Paris arrangement. The modern father of plastic surgery is, of course, Harold Gillies and, interestingly, he also was involved in nasal reconstruction with the war injured from World War I."
The National Army Museum reflects on the achievements of Gillies and notes, "Today, Gillies is often referred to as the `father of plastic surgery.
Many of the techniques he developed during the First World War are still used in modern reconstructive surgeries. The concept of cosmetic surgery also emerged as a result of Gillies` work.
His desire to restore normal appearance, as well as functionality, was revolutionary. The surgery Gillies` patients received was born out of necessity.
Their situation was a far cry from the purely cosmetic facelifts and nose jobs we see today!"