America's first plastic surgeon of note was Dr. John Peter Mettauer, who was born in Virginia in 1787. The colorful Dr. Mettauer performed the first cleft palate operation in the New World in 1827 with instruments he designed himself. Never before had physicians been required to treat so many and such extensive facial and head injuries. Shattered jaws, blown-off noses and lips and gaping skull wounds caused by modern weapons required innovative restorative procedures. In the United States, plastic surgeons like Varaztad Kazanjian of Boston and Vilray Blair of St. Louis nobly served both their country, and humanity, in those years.
Plastic surgery includes both the reconstructive and aesthetic subspecialties.
Despite the great leaps forward in plastic surgery after World War I, the profession was still rather ill-defined in the American medical establishment in the 1920s. Physicians specializing in this area had no formal means to share their new knowledge and innovations with like-minded physicians across the country. What was needed was a professional organization. In this case, it was two surgeons from Europe who came to the United States after World War I, Jacques Maliniac and Gustave Aufricht. The two doctors were as unalike as any two men could be, except for their dedication to their craft.