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In 1818, German cosmetic surgeon Carl Ferdinand von Graefe released his major work entitled. Von Graefe customized the Italian method utilizing a totally free skin graft from the arm instead of the initial delayed pedicle flap. The first American plastic cosmetic surgeon was John Peter Mettauer, who, in 1827, performed the first cleft palate operation with instruments that he created himself.

Another case of cosmetic 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 decreased a dorsal nasal bulge for cosmetic indications. In  Solution Can Be Seen Here , Robert Weir explored unsuccessfully with xenografts (duck breast bone) in the reconstruction of sunken noses.

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In 1898, Jacques Joseph, the German orthopaedic-trained cosmetic surgeon, published his first account of decrease nose job. In 1928, Jacques Joseph released Nasenplastik und Sonstige Gesichtsplastik. [] Advancement of contemporary strategies [edit] The father of modern-day plastic surgical treatment is normally thought about to have been Sir Harold Gillies. A New Zealand otolaryngologist operating in London, he developed a number of the strategies of modern facial surgery in caring for soldiers struggling with disfiguring facial injuries during the First World War.

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After dealing with the renowned French oral and maxillofacial cosmetic surgeon Hippolyte Morestin on skin graft, he persuaded the army's chief cosmetic surgeon, Arbuthnot-Lane, to develop a facial injury ward at the Cambridge Military Healthcare Facility, Aldershot, later on upgraded to a new health center for facial repair work at Sidcup in 1917. There Gillies and his associates established lots of techniques of plastic surgical treatment; more than 11,000 operations were performed on more than 5,000 guys (primarily soldiers with facial injuries, normally from gunshot wounds). [] After the war, Gillies established a private practice with Rainsford Mowlem, consisting of numerous popular patients, and travelled extensively to promote his advanced techniques worldwide.

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When World War II broke out, cosmetic surgery provision was largely divided in between the various services of the armed forces, and Gillies and his team were divided up. Gillies himself was sent to Rooksdown Home near Basingstoke, which ended up being the principal army cosmetic surgery system; Tommy Kilner (who had worked 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 Healthcare facility, Roehampton; and Mowlem went to St Albans.