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In 1818, German cosmetic surgeon Carl Ferdinand von Graefe published his major work entitled. Von Graefe modified the Italian technique utilizing 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, carried out the first cleft taste buds operation with instruments that he developed himself.

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Another case of plastic surgical treatment for nose restoration from 1884 at Bellevue Medical facility was described in Scientific American. In 1891, American otorhinolaryngologist John Roe presented an example of his work: a young lady on whom he lowered a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck breast bone) in the reconstruction of sunken noses.

In 1898, Jacques Joseph, the German orthopaedic-trained cosmetic surgeon, published his first account of reduction rhinoplasty. In 1928, Jacques Joseph released Nasenplastik und Sonstige Gesichtsplastik. [] Development of modern methods [modify] The father of modern plastic surgery is usually thought about to have been Sir Harold Gillies. A New Zealand otolaryngologist operating in London, he developed many of the techniques of modern facial surgical treatment in caring for soldiers suffering from damaging facial injuries during the First World War.

After dealing with the renowned French oral and maxillofacial cosmetic surgeon Hippolyte Morestin on skin graft, he persuaded the army's chief surgeon, Arbuthnot-Lane, to develop a facial injury ward at the Cambridge Military Health Center, Aldershot, later updated to a brand-new medical facility for facial repair work at Sidcup in 1917. There More Details and his colleagues established lots of techniques of plastic surgical treatment; more than 11,000 operations were carried out on more than 5,000 males (primarily soldiers with facial injuries, usually from gunshot wounds). [] After the war, Gillies established a private practice with Rainsford Mowlem, including lots of popular patients, and travelled thoroughly to promote his innovative strategies worldwide.

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When The Second World War broke out, cosmetic surgery provision was mostly divided between the different services of the militaries, and Gillies and his team were broken up. Gillies himself was sent to Rooksdown Home near Basingstoke, which ended up being the principal army plastic surgery unit; Tommy Kilner (who had actually worked 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 Medical facility, Roehampton; and Mowlem went to St Albans.