The desire for beauty has a 3,000-year history: exploring the origins of cosmetic surgery

The desire to appear young and beautiful dates back to the dawn of civilization, and cosmetic surgery has a history stretching over 3,000 years. This is revealed in a study published by Harper’s Bazaar, the renowned international fashion magazine, which traces the long journey of aesthetic practices throughout centuries — and millennia — to uncover the earliest roots of what we now call cosmetic procedures.

The term “plastic surgery” comes from the Greek plastikos, meaning “to mold” or “to give form.” Interestingly, its origins appear to be more reconstructive than aesthetic.

According to various scholars, one of the earliest references to rudimentary aesthetic surgery is found in the ancient Egyptian medical text known as the Edwin Smith Papyrus. Likely conceived as a manual for trauma surgery, it contains remarkably advanced observations for its era and sheds light on how Egyptians treated wounds and fractures. The papyrus also explains nasal injury management using manual repositioning, wooden splints, linen plugs and packing materials.

However, other historians argue that the true aesthetic roots of plastic surgery lie in India. In research published in the European Journal of Plastic Surgery, scholar Justin Yousef attributes the earliest records of nasal reconstruction to ancient India. In the 6th century BC, Sushruta — considered the father of plastic surgery — described in the Sushruta Samhita an incredibly sophisticated technique for creating skin flaps. Motivations were often cosmetic, but also linked to punitive practices: in ancient India, adulterers often had their noses amputated. Paradoxically, this contributed to refining Sushruta’s method, which involved reconstructing the nose using skin from the forehead.

In Ancient Rome, the pursuit of aesthetic perfection was equally strong. Romans admired the ideal body and viewed congenital or trauma-related deformities with suspicion. In De Re Medicina (14–37 AD), Aulus Cornelius Celsus described procedures to conceal back scars, reduce gynecomastia, and repair ear and nasal defects using skin flaps. His work remained the leading surgical reference for nearly 1,700 years.

In Italy, during the 15th century, the art of reconstructive surgery was preserved within renowned medical families. In Sicily, Dr. Branca revived the Indian nasal reconstruction technique, passing it only to his son. The Branca family — and later the Boiardi family in Calabria — became known for the “Italian method” of reconstructing noses, lips, and ears.

The modern era of cosmetic surgery truly began in the 19th century with the invention of anesthesia, which revolutionised surgical practice. Wars between the late 1800s and early 1900s accelerated progress: advances in anesthesia, the use of sulfonamides, blood transfusions and penicillin dramatically reduced mortality and infection rates. Surgeons learned to use iliac bone for facial reconstruction, and in 1895 Dr. Czerny performed the first breast augmentation using the patient’s own tissue.

From that point onward, technological innovation and scientific discovery have shaped contemporary cosmetic surgery — a field that continues to evolve and refine itself today.

by Maria Serena Patriarca