Plastic Surgery from WWI to Cosmetic Surgery in the Modern World

As soldiers with severe injuries increased due to the explosive weapons in WWI, medical technology developed rapidly with plastic surgery. Plastic surgery was pioneered by Sir Harold Delf Gillies to treat injuries or scars, and this new type of surgery was helpful not only for functional reasons but also for cosmetic reasons since it could end the trauma of facial injuries. Starting from treating injuries and scars, now it’s more widely spread for cosmetic reasons. As social standards of beauty changed, plastic surgery became a billion-dollar business. 

During WWI, weapons like heavy artillery, machine guns, and poison gas were used which resulted in severe injuries to soldiers. Facial wounds were so severe that they left soldiers unable to eat, drink, or even speak. To treat these serious facial injuries, which functionally caused problems, Sir Gillies pioneered facial reconstruction surgery. Before his new technology, surgeons stitched the skin without replacing the lost skin. Eventually, this caused another problem. The face became distorted as the flesh tightened while the scars were healed. Reconstruction surgery, also called plastic surgery nowadays, could fix these problems. Sir Gillies was a New Zealand surgeon who served with the Royal Army Medical Corps in England. Getting inspired by Hippolyte Morestin, a French surgeon who was one of the founders of cosmetic surgery, Sir Gillies established The Queen’s Hospital after seeing the horrific injuries from soldiers. The purpose of the hospital was to help seriously injured soldiers get back to their normal lives by reconstructing their faces as closest to their original faces. (National Army Museum)

Gillies discovered new skin grafting techniques like skin flap surgery which is to lift a large pedicle flap near the wound, free the end of the skin flap which would be still connected to the donor site, and put it over to the site of the injury without completely separating from the body. 

Walter Yeo, a sailor, before (left) and after (right) skin flap surgery performed by Gillies in 1917 (Wiki Commons included in National Army Museum). 

During the operation of Whillie Vicarage, who could not shut his eyes or mouth due to the fixed scarred mask from burns during the Battle of Jutland (1916), he found out that the tubed pedicle flap helped to reduce the risk of infection and blood supplies. Whillie had a burned face with a fixed scarred mask so that he couldn’t move his eyes or mouth. As he raised another pedicle flap from Whillie’s chest, he decided to sew the curled pedicle flaps. After sewing, he found out that the risk of infection was reduced with better blood supply. Also, it was possible to graft wider areas once it was cut off from the donor site.

Facsimile of a wax teaching model made by Sergeant Thomas H Kelsey for the New Zealand Medical Corps facial and jaw injury unit, 1917 (c) [Image number: 184211] (National Army Museum) 

These works later made a huge advancement in reconstructing faces and the foundation of modern plastic surgery (National Army Museum). Though the plastic surgery technologies from WWI were innovative, there were still issues like infection problems, surgical shock (blood loss), and good anesthesia (Johns Hopkins Medicine). 

As mentioned earlier, soldiers who got surgery before Sir Gillies pioneered plastic surgery had suffered from facial traumas and further lost their identity. Since the skins and bones were twisted from burning steel pieces, their faces were distorted. Because of this, the soldiers were afraid to meet anyone, even their family. Yet after Gillie had pioneered facial reconstruction surgery, the soldiers could live a pretty normal life even if the scars were not one hundred percent gone. “These advances were made very quickly in this field because of an effort to make it seem like what had happened to these soldiers was not so horrible,” said Jane Cart, surgery historian for the University of Michigan (Donvito, Tina). Starting with Sir Gillies’s new technology, people started to care about the cosmetic reasons for surgeries instead of only the functional ones. This had brought cultural and social standards of beauty to change and as people’s interest in cosmetics increased, plastic surgery began to change more into cosmetic surgery. 

Like the quote, “Plastic surgery is such a big part of our culture,” said Gordon Lee, a plastic and reconstructive surgeon at Stanford University in California (Sally Meeson), plastic surgery has now become a culture worldwide. Nowadays, people do plastic surgeries for various reasons such as to boost their self-esteem, and self-confidence and to improve their quality of life even if they do not have facial traumas (Melissa Dittmann). Plastic surgery is so common that if we look at the most popular surgery, we can see the changes in beauty ideals. For example, Dr. Michelle Smith, Research Fellow in English Literature at Deakin University said, “In the late 19th century breast reductions were more common…”. However, now, breast augmentation surgery is the most common surgery in many big countries like the USA(Niall Mccarthy) and the UK (Martin Armstrong) which means people prefer bigger breasts. Also, lip augmentation surgery became popular as multiculturalism in Western countries increased (Michelle Smith). Many different factors are changing the beauty norms as they change the plastic surgery trends. 

Although plastic surgery has now taken root in our culture, there are many negative sides too. Since people are doing plastic surgery for their satisfaction, they would do it until the result came out as they wanted. For example, there is a high chance that it would not be the same as expected because since it is using artificial materials, it’s hard to predict how bodies would react to it. There is a chance that the position of the prosthesis changes which would lead to another surgery even if it is costly. This would make them do it over again which would keep damaging the skin and muscle. Since the skin is now sagging, they would get Botox which seems like it’s working but because it’s affecting muscle not tightening the skin itself, it’s not permanent (Myhoussurge) so they should get an injection periodically. Yet, still, many people get plastic surgery because it’s now a part of hot trends. 

Plastic surgery was first pioneered by Sir Gillies for functional reasons, but as the technology developed, it is now commonly used as a tool for self-satisfaction. However, the new skin grafting techniques from Sir Gillies have been a base for modern plastic surgery. Even if it has some negative effects like requesting to repeat the surgery, plastic surgery plays a huge role in knowing the beauty trends over the globe as part of modern culture.

Works Cited 

“After Surgery: Discomforts and Complications.” Johns Hopkins Medicine, ts-and-complications. 

Armstrong, Martin, and Felix Richter. “Infographic: The UK’s Most Popular Plastic Surgery.” Statista Infographics, 21 May 2019, 

Bamji, Dr Andrew. “The First World War and the Development of Facial Surgery.” The PMFA Journal, cial-surgery. 

“The Birth of Plastic Surgery.” National Army Museum, (also image1) 

Donvito, Tina, and Jacopo della Quercia. “20 Cool Everyday Things That Were Actually Designed for WWI.” Reader’s Digest, Reader’s Digest, 31 Mar. 2021, 

“Hippolyte Morestin.” Wikipedia, Wikimedia Foundation, 6 Apr. 2021, 

McCarthy, Niall, and Felix Richter. “Infographic: America’s Love Affair With Plastic Surgery.” Statista Infographics, 12 Mar. 2019,

Meeson, Sally. “Why Plastic-Surgery Demand Is Booming amid Lockdown.” BBC Worklife, BBC, 17 Sept. 2020, d-lockdown. 

Myhoussurge. “Botox Maintenance: How Often Should You Get Botox?” My Houston Surgeons Cosmetic Reconstructive Sinus, My Houston Surgeons, 3 July 2019, 

“Online Collection (National Army Museum).” Facsimile of a Wax Teaching Model Made by Sergeant Thomas H Kelsey for the New Zealand Medical Corps Facial and Jaw Injury Unit, 1917 (c) | Online Collection | National Army Museum, London, (image2) 

Smith, Michelle. “How Plastic Surgery Trends Reflect Changing Beauty Ideals.” This., 10 Apr. 2018,

By. Dain Chang