How a Stab Wound in 1884 Gave Rise to Korea’s Plastic Surgery Empire

South Korea today performs more aesthetic surgical procedures per capita than any nation on Earth, and its national plastic surgery society ranks as the third largest in the world. Yet according to a new narrative review published in BMC Plastic and Reconstructive Surgery, the specialty’s origins trace back not to a grand scientific program but to a single emergency operation performed by a barely trained missionary physician on a wounded aristocrat in December 1884. The review, written by Daihun Kang of Ewha Womans University Seoul Hospital, reconstructs the complete 142-year arc of Korean plastic and reconstructive surgery using society archives, founding surgeons’ memoirs, wartime medical records, and institutional histories, and it argues that the field’s spectacular rise was shaped as much by historical accident as by deliberate design.

The founding moment arrived amid political violence. On December 4, 1884, reformist officials staged the Gapsin Coup, a failed modernization attempt launched during a banquet celebrating the opening of Korea’s first postal office. Among those attacked was Min Young-ik, a nephew of Queen Min, who sustained seven severe sword wounds and was left for dead. Court physicians using traditional methods doubted he would survive. Paul Georg von Möllendorff, a German diplomat serving as the first Western advisor to King Gojong, summoned Horace Newton Allen, an American Presbyterian medical missionary who had arrived in Korea only three months earlier. Allen cleaned and sutured the wounds, applied antiseptic dressings, and managed infections with improvised techniques, including what he described as applying baked mud to absorb pus before washing with water. Over roughly three months, and despite the objections of fourteen court medicine men, Min made a complete recovery.

The operation transformed elite attitudes toward Western medicine. A grateful King Gojong approved Allen’s proposal for a medical center in Seoul, and on April 10, 1885, Gwanghyewon, Korea’s first government-supported Western hospital, opened its doors. Renamed Jejungwon just twelve days later, the institution began training Korean medical assistants and, in 1886, opened Korea’s first Western medical school. The hospital later became Severance Hospital in 1904, funded by American philanthropist Louis Severance, and in 1957 merged with Yonhi University to form Yonsei University. The institutional lineage is striking: the department where Korea’s first plastic and reconstructive surgery unit was founded in 1961 stands on the institutional foundation laid by Allen seventy-six years earlier.

The review also complicates the conventional heroic narrative of this founding. Drawing on the historian Lee Young-ah’s 2011 study, Kang notes that Allen had completed only a one-year medical program and admitted in an 1887 letter that he felt incompetent to handle major operations. Hospital records document amputations performed without lengthy consultation with patients, and Allen once extracted a healthy tooth alongside a decayed one without disclosing the error. Kang argues that the specialty’s genealogy therefore originates not with a master surgeon but with a minimally trained physician operating under conditions of radical medical, cultural, and political asymmetry. The founding, in the most literal sense, was an improvisation, doubly contingent on a failed coup and on the presence of the only available Western physician with enough skill and ambition to build an institution from the result.

For decades afterward, reconstructive surgery remained undeveloped in Korea, including under Japanese colonial rule from 1910 to 1945. Yet the cultural seeds of the country’s later aesthetic surgery boom were planted in this era. A 2024 study in the Journal of Craniofacial Surgery documented that by 1935, double eyelids had become a recognized symbol of modern beauty in Korea. Oh Yeop-ju, Korea’s first female hairdresser, underwent double-eyelid surgery at a Japanese clinic between 1927 and 1932, and after returning home in 1933 she shared her detailed account of the technique with Seoul’s Kong Eye Center, which began offering the procedure in 1937. These early precedents established the dual reconstructive and aesthetic orientation that would later define Korean practice.

The decisive catalyst was the Korean War of 1950 to 1953, which created reconstructive needs on a staggering scale. An estimated two to three million civilians perished, representing between 50 and 74 percent of all war casualties, a proportion exceeding that of either World War II or the Vietnam War, while 397,519 South Korean soldiers required hospitalization. Congenital conditions compounded the burden: cleft lip and palate occur at roughly twice the rate in Asian populations, about one in 500 births, compared with one in 1,000 in Caucasian populations. Into this environment came Dr. D. Ralph Millard Jr., Chief Plastic Surgeon of the U.S. Marine Corps in Korea from 1954, who described the country as a plastic surgeon’s paradise. Operating on Korean children, Millard developed his rotation-advancement flap for cleft lip repair, first presented at the 1955 International Congress of Plastic Surgery in Stockholm and now used by 84 percent of cleft surgeons worldwide. He also popularized Asian blepharoplasty and introduced rhinoplasty techniques adapted to Korean facial anatomy, and the American Society of Plastic Surgeons later named him one of the ten plastic surgeons of the millennium.

Foreign surgeons, however, could not build a lasting domestic specialty on their own. That task fell to systematic postwar partnerships, above all the Minnesota Project of 1954 to 1962, a U.S.-sponsored exchange between Seoul National University and the University of Minnesota that sent 226 young Korean faculty members to study in the United States while 59 American academics came to Seoul, at an annual cost of roughly 750,000 dollars, equivalent to about 7.1 million dollars in 2020. The project produced the generation of physicians who would establish specialty departments nationwide. Its most consequential product for plastic surgery was Dr. Lew Jae-duk, born in 1930 in Haeju in what is now North Korea, who fled south in 1946 and was wounded by a grenade during the war while a medical student. After graduating from Yonsei Medical College in 1954, Lew trained in Pennsylvania under Dr. Kerwin Marcks and passed the American Board of Plastic Surgery examination in July 1961, with a local newspaper describing him as the only board-certified plastic surgeon in that nation. On August 31, 1961, he founded Korea’s first plastic and reconstructive surgery department at Yonsei University Severance Hospital, a date still commemorated annually, and went on to report a series of 2,422 cleft lip and palate cases accumulated over twenty years.

From that single department, the specialty expanded through two parallel schools of pioneers. Lew’s disciples established programs across the country: Dr. Min Dae-Hong founded the department at Chung-Ang University in 1972, the first in Seoul outside Yonsei, and his trainee Dr. Kim Han-Joong established the Ewha Womans University program in 1978, which later became one of Seoul’s major burn treatment centers and conducted humanitarian cleft missions in Vietnam in 1995 and 1996, treating 164 patients. Dr. Seul Jung-Hyun, trained directly under Lew, founded the Yeungnam University department in 1983, extending the specialty into southeastern Korea. Meanwhile, independently trained pioneers who had studied in American and Japanese programs diversified the field’s intellectual foundations. The Korean Society of Plastic and Reconstructive Surgeons was inaugurated on May 15, 1966, with about 30 members drawn from several surgical disciplines; in October 1973 the government designated the field the nation’s nineteenth independent medical specialty; and in 1975 the first board examination produced 22 certified specialists. Microsurgery arrived through Professor Sun Lee’s first Korean microvascular workshop in 1975, enabling pioneering achievements including the first replantation of an amputated thigh, the first toe-to-thumb transplantation, and the first groin free flap.

The review organizes this history into five phases: wartime introduction from 1945 through the 1960s, institutional foundation from 1966 to 1975, technical specialization from 1975 to 1985, aesthetic emergence from 1985 to 2000, and internationalization from 2000 to the present. In the current phase, the society transformed its journal into the English-language Archives of Plastic Surgery in 2012, achieving indexing in the Emerging Sources Citation Index in 2016, while the government’s Medical Korea initiative made aesthetic surgery a pillar of medical tourism centered on Seoul’s Gangnam district. Korean surgeons also refined facial contouring procedures such as mandibular angle reduction and reduction malarplasty for East Asian patients, and reconstructive subspecialties advanced with breast reconstruction’s inclusion in national health insurance in 2015 and the rise of supermicrosurgical lymphedema techniques such as lymphaticovenous anastomosis and vascularized lymph node transfer.

Yet Kang’s conclusion is deliberately sobering. By 2026, more than 2,800 specialists had been certified, a density of roughly 5.5 per 100,000 people, but commercial demand has concentrated in aesthetic practice, accelerating the migration of surgeons from academic hospitals to private clinics and leaving the reconstructive sector understaffed. Plastic surgery has not been classified as an essential medical service in Korea, and reimbursement rates for reconstructive procedures remain low, discouraging young surgeons from academic reconstructive careers. The specialty’s international reputation, Kang notes, was built on reconstructive innovation, from Millard’s wartime cleft repairs to the microsurgical advances of the 1970s and 1980s, and the reconstructive mission that defined its emergence now requires careful stewardship by those who inherit it. No participant in the events of December 4, 1884, he writes, intended any of what followed, and the current generation inherits both the achievement and the obligation to remember where it began.

Subject of Research: Historical development of plastic and reconstructive surgery in Korea from 1884 to 2026

Article Title: From a stab wound to a surgical specialty: a narrative review of the historical development of plastic and reconstructive surgery in Korea, 1884–2026

Article References: From a stab wound to a surgical specialty: a narrative review of the historical development of plastic and reconstructive surgery in Korea, 1884–2026. (n.d.). https://doi.org/10.1186/s44452-026-00027-7

Image Credits: AI Generated

DOI: 10.1186/s44452-026-00027-7

Keywords: plastic surgery, reconstructive surgery, South Korea, Korean War, medical history, Horace Allen, Jae-duk Lew, D. Ralph Millard, microsurgery, aesthetic surgery, KSPRS, Severance Hospital