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In 1818, German cosmetic surgeon Carl Ferdinand von Graefe published his significant work entitled. Von Graefe modified the Italian approach using a totally free skin graft from the arm rather of the initial delayed pedicle flap. The first American plastic surgeon was John Peter Mettauer, who, in 1827, carried out the very first cleft taste buds operation with instruments that he designed himself.

Another case of plastic surgery for nose reconstruction from 1884 at Bellevue Hospital was described in Scientific American. In 1891, American otorhinolaryngologist John Roe presented an example of his work: a girl on whom he reduced a dorsal nasal hump for cosmetic signs. In 1892, Robert Dam experimented unsuccessfully with xenografts (duck sternum) in the restoration of sunken noses.

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In 1898, Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of decrease nose surgery. In 1928, Jacques Joseph released Nasenplastik und Sonstige Gesichtsplastik. [] Development of contemporary techniques [edit] The father of contemporary plastic surgery is usually considered to have been Sir Harold Gillies. andrew p trussler operating in London, he developed much of the strategies of contemporary facial surgery in looking after soldiers experiencing damaging facial injuries during the First World War.

After dealing with the popular French oral and maxillofacial cosmetic surgeon Hippolyte Morestin on skin graft, he convinced the army's chief surgeon, Arbuthnot-Lane, to develop a facial injury ward at the Cambridge Armed Force Health Center, Aldershot, later upgraded to a new healthcare facility for facial repair work at Sidcup in 1917. There Gillies and his colleagues established many techniques of cosmetic surgery; more than 11,000 operations were performed on more than 5,000 guys (mostly soldiers with facial injuries, typically from gunshot injuries). [] After the war, Gillies developed a personal practice with Rainsford Mowlem, including lots of famous patients, and took a trip thoroughly to promote his innovative methods worldwide.

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When World War II broke out, cosmetic surgery provision was largely divided in between the different services of the militaries, and Gillies and his group were broken up. Gillies himself was sent out to Rooksdown Home near Basingstoke, which became the primary army cosmetic surgery system; Tommy Kilner (who had dealt with Gillies throughout the First World War, and who now has a surgical instrument called after him, the kilner cheek retractor) went to Queen Mary's Hospital, Roehampton; and Mowlem went to St Albans.