West’s First Modern Plastic Surgery

On this day in 1814, London surgeon and anatomist Joseph Constantine Carpue performed what is considered the West’s first modern plastic surgery operation on a British military officer in the Duke of York Hospital in Chelsea, England.

Carpue was fascinated with Indian and Islamic medical sciences, which had made great advances in plastic surgery several centuries earlier. In fact, after reading reports on Indian rhinoplasty operations performed on disfigured Indian soldiers serving the British in Gentleman’s Magazine in 1794, Carpue traveled to India and spent 20 years studying local plastic surgery methods there.

His fascination continued when he returned to Chelsea, where he worked mainly in the Duke of York Hospital as a surgeon and anatomist. He continued his research on plastic surgery in London and when a suitable patient finally approached him, Carpue prepared to perform the first nose reconstruction operation in Britain.

The patient was an army officer who had lost much of his nose to the toxic effects of mercury treatments, used at the time to treat some diseases. Carpue cut loose a strip of skin from the patient’s forehead, twisted it and folded it down over the nose, secured it to incisions in the nasal area, and molded the new nose into shape. The patient’s face was bandaged for several days as he lay immobile on his back. According to legend, when the bandages were eventually removed from the patient’s face, Carpue shouted, ‘My God, there is a nose!’

The operation was considered a stunning success. Because the flap of skin constructing his new nose was the patient’s own, his body accepted the graft, and with little scarring. Carpue later repeated the same operation on another patient, and then published his account in ‘An Account of Two Successful Operations for Restoring a Lost Nose from the Integument of the Forehead’.

Western medicine owed a debt to Carpue for this, the first successful modern rhinoplasty in the west. And Carpue, in turn, owed a debt to the East, which pioneered the medical science as early as 800 BC, when the first known reconstructive surgery techniques were being performed. The ancient Indian surgeon known as Sushruta, father of surgery, made important advances in the field of plastic surgery and cataract surgery in the 6th century BC. And the Islamic Abbasid caliphate translated the Sanskrit works of these early Indian surgeons into Arabic in 750, which later spread via intermediaries, enriching the medical sciences of the Arab world and Europe.

To this day, surgeries using living grafts from a patient’s own skin, like the one Carpue performed in Chelsea in 1814, are called Indian plastic surgery.