Medical Progress And The Physician


THERE is hardly any other department of surgery which has made such remarkable technical progress within recent years as that branch known as “plastic surgery”—the repair of deformities, especially around the face. And this advance has been made not through any new discovery, but through a continual improvement on the part of individuals and their ability to do this very delicate and difficult work.

Far from new, it is, on the contrary, one of the oldest branches of the surgical specialties, the first famous operator being named Tallacotti, who flourished about 1597. The pictures in his surgery are so remarkably like the operations that are done today in plastic surgery as to be quite modern.

For instance, a modern plastic surgeon, in remaking a nose, will often have to take a large area of skin from the arm, and inasmuch as it is a principle of tissue grafting that the only thing likely to live is an autograft or, in other words, tissues taken from the same individual, the skin for the new nose must be taken from the patient’s own body.

In order to do this, the plastic surgeon cuts a flap of skin off the arm, but leaves the base of it intact in order that it will get a good blood supply. He then bandages the patient’s arm to his head so that the graft is held in place after he sews it on to the nose. The work requires quite as much patience and courage on the part of the patient as it does on the part of the surgeon.

Exactly similar conditions are found represented in Taliacotti’s old text-book published before 1600.

The results of all these things are quite remarkable. Such congenital diseases as harelip and cleft palate are today remedied with four or five times the success that previously met such efforts. The treatment of burns and injuries of the face allows us to restore conditions practically to the ideal cosmetic condition. For cosmetic purposes, plastic surgeons can not only lift the face, but lift the neck. The operation for the treatment of “gobbler neck” is called “cervico-rhytidectomy.” Mongolian eyes are made to look Occidental; large noses, small; small noses, large. In fact, you can have nearly any kind of physiognomy that you want with the help of the modern plastic surgeon.