Cosmetic Surgery and Facial Rejuvenation
The early twentieth century saw a demand for cosmetic surgery, especially facial rejuvenation. During this time, facelifts were performed by simply pulling on the skin on the face and cutting the loose parts off. The first facelift was reportedly performed by Eugen Holländer in 1901. An elderly Polish female aristocrat asked him to “lift her cheeks and corners of the mouth.” After much debate, he finally proceeded to excise an elliptical piece of skin around the ears. It was crude, but effective. Facelifts were often done in secrecy because both the patient and surgeon did not want to publicize the fact. Eventually, in 1907, a textbook totally devoted to facial cosmetic surgery was published by Charles Miller. In 1919, a more formal facelift procedure was described by Raymond Passot. This led to many others writing about their version of the technique. The first female plastic surgeon, Suzanne Noël, also played a large role in the development of facial cosmetic surgery.
Plastics: A New Classification and a Brief Exposition of Plastic Surgery.
David Prince. Philadelphia: Lindsay and Blakiston, 1868.
David Prince was an American military surgeon who served under General McClellan during the Civil War. Prince, who was very progressive in his ideas, was a strong proponent of antisepsis and the use of ether. His Prince Infirmary treated over three thousand patients a year, and he consequently had considerable experience in burn surgery and cleft palate surgery. In this book, Prince discusses various topics in plastic surgery, with a heavy emphasis and detailed discussions of rhinoplasty and cheiloplasty (lip surgery). Other topics in plastic surgery are reviewed as well.
The Expression of the Emotions in Man and Animals.
Charles Darwin. London: John Murray, 1872.
Charles Robert Darwin was an English geologist, naturalist, and biologist who is best known for his contributions to the science of evolution. His groundbreaking book, On the Origin of Species, was published in 1859. In The Expression of Emotions, which was his third work on evolutionary theory, Darwin studies the biologic aspects of emotional life, including such mannerisms as raising an eyebrow in surprise or blushing when embarrassed. These physical findings may be sought after when a surgeon performs surgery on the face to recreate a certain characteristic or trait, and this book is the first to discuss the biology behind it.
Personal Appearance and the Culture of Beauty.
Thomas Sozinskey. Philadelphia: Allen, Lane and Scott, 1877.
Thomas Sozinskey was a late 19th-century physician and author. In this book meant for the layperson, Sozinsky describes what makes each part of the human body beautiful. He has chapters dedicated to men and women individually and then not only discusses each part of the face but also writes about the teeth and skin. His is a purely subjective analysis, but this is important since at that time more physicians and surgeons were starting to deal with the art of cosmetic and aesthetic surgery. He discusses human beauty as it was presented to us through ages past by painters, sculptors, and artists.
John Woodbury. New York: G. W. Dillingham Co., 1910.
John H. Woodbury was an American self-trained dermatologist in the late 19th and early 20th centuries. In his youth he had a large facial nevus, or mole, on his face. His self-esteem improved after successfully having it removed, and he realized the significance that surgery can have on a person’s life. He built an empire of cosmetic surgery institutes in six states, with scores of physicians and employees. He and his colleagues performed numerous facial cosmetic surgeries of the face, forehead, cheek, nose, and chin. These procedures were described not in peer-reviewed journals and books but rather through advertisements for the public, and so he was fairly unknown in medical and academic circles. In addition, he started a proprietary cosmetic line that was very lucrative and was later sold to the Jergens Company. In this book, Woodbury discusses both dermatologic and surgical means to restore and maintain facial rejuvenation. Not only does he discuss topical creams, ointments, and medications, but he also discusses electrolysis, vibrations, and message. He also considers surgery, but not with the reverence that other true surgeons of the day were practicing. He incorporated all these modalities into his practices, so it is easy to see why he maintained a large following. Eventually this type of practicing and advertising became illegal, and his practices started to fail; he later admitted he was not even a medical doctor. Despite this infamy, he did have historically significant achievements.
The Correction of Featural Imperfections.
Charles Miller. Chicago: Charles Miller (Oak Printing Co.), 1907.
Charles Miller was an early 20th-century plastic surgeon credited with the first textbook specifically related to cosmetic surgery. The work was ahead of its time, and it was criticized for discussing procedures that were not life preserving or altering. The specialty was even considered “quackery” by many of the other general and reconstructive surgeons of that time. Many others in the medical community also considered Miller a quack, putting him in a similar category as Woodward and Crum even though he had formal training and his procedures were sound. In this book, Miller addresses the correction and rejuvenation of the eyes, ears, cheek, face, and neck, with procedures on both the skin and muscle.
Plastic and Cosmetic Surgery.
Frederick Kolle. New York: Appleton and Co., 1911.
Frederick Kolle was a late 19th-/early 20th-century German plastic surgeon who initially had radiology training and was one of the first pioneers of x-ray technology. Kolle maintained an active practice in plastic surgery, and his impetus for writing this book was his feeling that there ought to be an authoritative textbook on the art of plastic surgery, which was quickly becoming more and more popular. He helped to legitimize plastic surgery as a specialty, and his writing a formal textbook describing detailed accounts and methods of plastic surgery would aid in this endeavor. He references surgical procedures from the preceding hundreds of years. In his attempt to publish an authoritative book, Kolle not only describes plastic surgical procedures but also discusses requirements for operating in the operating room and lays out principles of antisepsis, anesthetics, dressings, instrumentation and post-operative care.
“La chirurgie esthétique des rides du visage” [Aesthetic surgery of facial wrinkles].
Raymond Passot. La presse médicale 27 (1919).
Raymond Passot was an early 20th-century French plastic surgeon. Along with Dr. Hippolyte Morestin, Passot was responsible for advancing the field of plastic surgery in France. In the early 20th century, cosmetic surgery was becoming increasingly popular, as was facial rejuvenation. This led to surgeons with large egos debating who performed the first facelift. Hollander claimed to have performed a facelift in 1901 on a Polish aristocrat, and Lexer claimed to have performed one in 1906 for an actress. Even the esteemed Joseph claimed one in 1912. But despite those claims, in 1919 Passot first published this article, appearing in La presse médicale, which describes the details in full. This procedure details where the incisions were made, then goes on to discuss the elevation and redraping of the skin. Today’s facelifts may be more advanced and sophisticated—and safer—yet the objectives remain the same.
Charles Willi. Somerset: Purnell and Sons, 1926.
Charles Willi was another surgeon of question in the early 20th century despite publishing books on plastic surgery and even maintaining a successful plastic surgery practice for over fifty years. His claim to have earned a medical degree in the United States was later deemed false because the head of the awarding university was convicted of running a fake diploma mill and thus Willi’s qualification was bogus. This led to a prosecution and fine but, because of a loophole in British law, Willi was able to practice plastic surgery as long as he did not willfully pass himself off as a physician or surgeon. In this book on facial rejuvenation Willi, however one regards his training and background, does discuss in detail many facial plastic surgery operations complete with pre-operative and post-operative photographs. Willi and these other so-called “beauty docs” did practice with the advantage of allowing them to advertise where other physicians could not. The one major disadvantage was an inability to work with anesthetists and use general anesthesia, so these facial cosmetic procedures were performed under local anesthesia only. Anesthesiologists risked loss of license if known to practice with these unlicensed doctors. Even with the limitation of local anesthesia only, Willi was also known to have performed some “breast firming” procedures.
The Hygiene of Youth and Beauty.
Josif Ginsburg. Sydney, Australia: Cornstalk Publishing Co., 1927.
Josif Ginsburg was an early 20th-century Russian trauma and military surgeon who later turned his talents and skills to the rapidly growing field of cosmetic surgery. He relocated his practice to Los Angeles in the 1920s and, with the advent of Hollywood and movie stars demanding more cosmetic surgery, his practice thrived. In this book, like the other books involving cosmetic surgery, the emphasis is more on the non-academic and non-medical aspects of the field of plastic surgery. The writing addresses both surgical and non-surgical methods for restoring and rejuvenating not only the skin but facial complexion and hair as well. Chemical peels and skin care are also discussed.
Doctor Charles Conrad Miller’s Review of Plastic and Esthetic Surgery.
Charles Miller. Philadelphia: F. A. Davis and Co., 1927.
Charles Miller was also an eager publicist. In the inaugural issue of this softbound journal, he not only discusses cosmetic surgical procedures but also general surgical procedures for the practitioner. His journal is filled with medical and non-medical advertisements as well.
The Making of a Beautiful Face.
Howard Crum. New York: Walton Book Co., 1928.
J. Howard Crum was another of the so-called Beauty Docs of the early 20th century. He was a huge fan of publicity and would publicize the surgeries he performed. Like other practitioners of the time, he was frowned upon by the more legitimate practitioners; yet he did command a solid following. In this book, Crum discusses the medical, dermatologic, and surgical factors that go into making a beautiful face.
Chirurgie esthétique pure [Pure aesthetic surgery].
Raymond Passot. Paris: Chez Gaston Doin, 1931.
In this book Raymond Passot again reveals his expertise for cosmetic surgery. Not only are surgical techniques discussed, but Passot also shares with the reader how he examines patients and reveals his suturing techniques. Passot was very proud of his results, as is evidenced by actual before-and-after pictures of patients undergoing both facial cosmetic surgery and breast cosmetic surgery. At that time, breast enhancement procedures were limited to the correction of sagging breasts or enlarged breasts. It would be another thirty years until breast augmentation with implants would be performed.
La véritable chirurgie esthétique du visage [The real aesthetic facial surgery].
Julien Bourguet. Paris: Les petits-fils de Plon et Nourrit, 1936.
Julien Bourguet was a French surgeon in the 20th century. In this book Bourguet discusses cosmetic surgery of the nose, ears, eyes, mandible (chin), and face. Bourguet performed a lot of aesthetic surgery in France. Both the hard and soft tissues of the face are addressed. As medical photography was becoming more standard, the book is filled with numerous before-and-after pictures. This technique of “before-and-after” pictures has become the standard in today’s cosmetic surgery practices.
Your New Face Is Your Fortune.
Henry Schireson. Philadelphia: Franklin House, 1947.
Henry Schireson was also an early 20th-century “Beauty Doc.” Like Willi, he had little formal training and practiced outside professional organized medicine. He did not belong to professional societies and maintained no hospital privileges. He did not author articles or teach at medical schools. He was simply a flamboyant personality who advertised greatly and performed cosmetic surgery. Schireson rose to fame in 1923 when he operated on the nose of vaudeville star Fanny Brice. Alas, he too ran afoul of the law. He had legal trouble with his license and faced mounting malpractice claims. In this manual, he discusses the virtues of having a more perfect nose.