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In 1818, German cosmetic surgeon Carl Ferdinand von Graefe published his significant work entitled. Von Graefe customized the Italian method using a totally free skin graft from the arm instead of the original postponed pedicle flap. The first American plastic surgeon was John Peter Mettauer, who, in 1827, performed the very first cleft palate operation with instruments that he designed himself.

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Another case of plastic surgery for nose restoration from 1884 at Bellevue Healthcare facility was described in Scientific American. In 1891, American otorhinolaryngologist John Roe provided an example of his work: a young lady on whom he decreased a dorsal nasal hump for cosmetic indications. In  Keep Checking Back Here , Robert Weir experimented unsuccessfully with xenografts (duck breast bone) in the reconstruction of sunken noses.

In 1898, Jacques Joseph, the German orthopaedic-trained surgeon, released his very first account of decrease nose surgery. In 1928, Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik. [] Advancement of modern strategies [modify] The daddy of contemporary plastic surgery is usually considered to have actually been Sir Harold Gillies. A New Zealand otolaryngologist working in London, he established much of the methods of modern facial surgical treatment in taking care of soldiers struggling with damaging facial injuries throughout the First World War.

After dealing with the popular French oral and maxillofacial surgeon Hippolyte Morestin on skin graft, he convinced the army's chief cosmetic surgeon, Arbuthnot-Lane, to develop a facial injury ward at the Cambridge Armed Force Hospital, Aldershot, later on updated to a new health center for facial repairs at Sidcup in 1917. There Gillies and his colleagues developed numerous methods of plastic surgery; more than 11,000 operations were performed on more than 5,000 males (primarily soldiers with facial injuries, generally from gunshot wounds). [] After the war, Gillies developed a personal practice with Rainsford Mowlem, including many famous patients, and took a trip thoroughly to promote his advanced methods worldwide.

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When World War II broke out, plastic surgical treatment provision was mainly divided in between the various services of the militaries, and Gillies and his group were split up. Gillies himself was sent out to Rooksdown Home near Basingstoke, which became the principal army cosmetic surgery unit; Tommy Kilner (who had actually dealt with Gillies during the First World War, and who now has a surgical instrument named after him, the kilner cheek retractor) went to Queen Mary's Healthcare facility, Roehampton; and Mowlem went to St Albans.