First Plastic Surgery in Britain
Chelsea, London The 22nd of October 1814 AD
Western medicine owes a debt to both Islamic and Indian medical science, and it was learning from the latter that enabled Joseph Constantine Carpue, a London surgeon and anatomist of some renown, to perform the first rhinoplastic operation (nose reconstruction) in Britain in 1814, which in effect opened up the whole area of plastic surgery to modern European medicine. He had read an article 20 years previously in The Gentleman’s Magazine regarding such operations carried out on some Indian soldiers serving the British, these soldiers having been disfigured after falling into enemy hands.
Carpue worked mainly in the Duke of York Hospital in Chelsea . When he finally had a suitable patient, had researched in greater depth the way the operation was done on the sub-continent, and had nerve enough to perform the surgery, he achieved a stunning success. His patient was an army officer whose nose had been eaten away by the effects of mercury treatment for disease. The details of the operation are rather grisly, but in essence a flap of skin from the forehead was partially cut loose then twisted, folded down and attached to incisions in the nasal area, once scar tissue there had been cleaned away. The new nose was moulded into shape (‘plastic’ in the term plastic surgery coming from the Greek plastikos, meaning mould or form), and the whole cemented in place then bandaged for several days while the patient lay immobile on his back. As the flap was the patient’s own living tissue it took and left little visible scarring. Legend has it that when the bandages were eventually removed Carpue shouted: “My god, there is a nose!”
The operation was a breakthrough. Carpue repeated it, and two years later published ‘An Account of Two Successful Operations for Restoring a Lost Nose from the Integument of the Forehead’. For once the debt owed to the East was repaid, such surgery using living flaps of the patient’s own skin being called even today Indian plastic surgery.
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