The scope of the series, as outlined in the editorial, is deliberately broad. It will welcome research articles examining the foundation and evolution of plastic and reconstructive surgery, including studies of the contributions of individual surgeons and patients, the historical development of surgical techniques and instrumentation, and even the field’s reflections in art and literature. That breadth reflects a central claim of the editorial: every procedure, condition, surgical algorithm and instrument in the specialty carries its own story, and those stories collectively explain how modern practice came to look the way it does.

The historical arc the editorial sketches stretches back further than most readers might expect. It opens with ancient Sanskrit texts describing Sushruta’s procedure for nasal reconstruction, a reference to one of the earliest documented operations in which tissue was deliberately transferred to repair a defect of the face. Nasal reconstruction holds a special place in the origin story of the specialty because the nose, prominently exposed and vulnerable to injury, was among the most socially and functionally devastating losses a person could suffer. Techniques for rebuilding it developed across centuries and cultures, long before the term plastic surgery existed, and the editorial treats this ancient lineage as the starting point of a continuous tradition of innovation that runs unbroken to the present day.

From that ancient beginning, the editorial traces a path to the other end of the technological spectrum: modern robot-assisted surgery. The contrast is striking, but the authors’ point is that the two are connected by more than chronology. The principles that govern reconstruction today, such as careful wound closure, respect for tissue planes and the strategic transfer of tissue from one part of the body to another, were established through accumulated experience rather than invented overnight. Knowledge of this history, the editorial argues, is an important resource for understanding and respecting the sacrifices and contributions of the surgeons and patients whose experiences defined the techniques, principles and standards that define practice today.

A central and sobering theme of the editorial is the role of war. For the most part, the modern techniques used in plastic surgery took root in field army hospitals and were first performed by military surgeons, who were tasked with wound closures of varying complexity, extremity reattachments, burn treatments and other consequences of armed conflict. The scale and complexity of injury seen in the First and Second World Wars necessitated rapid surgical innovation, producing novel techniques in wound closure, reconstruction and microsurgery. Battlefield conditions, in this telling, functioned as an brutal forcing function: mass casualties with unprecedented combinations of injuries demanded solutions that civilian practice had never been required to develop at speed.

The editorial names a remarkable roster of contributors from the first half of the twentieth century, a period when the specialty crystallized into a distinct discipline. Among those listed are Sir Harold Gillies, Sir Robert Jones, Henry Pickerill, Hippolyte Morestin, Erich Lexer, Jaques Joseph, Otto Lanz, Johannes Esser, Vladimir Petrovich Filatov, Archibald McIndoe, Luke Voyno-Yasenetsky, Vincenz Czerny and Suzanne Noël. The list spans multiple countries and national traditions, underscoring that the birth of modern plastic surgery was an international enterprise rather than the achievement of a single school. Several of these names remain familiar to surgeons today through eponymous flaps, instruments and techniques that are still taught in training programs around the world.

What distinguishes this editorial from a conventional celebration of surgical pioneers is its insistence on remembering the other half of the partnership: the patients. It is equally important, the authors write, to remember the soldiers and civilians whose injuries compelled the marvelous surgical progress from which patients continue to benefit today. Their suffering and sacrifice are often overshadowed by the focus on the surgeon or the technique, but their experiences are a reminder that the history of surgery carries a tremendous human cost that must never be forgotten. This reframing is significant for how the series is likely to approach its subject. Rather than treating historical patients as passive material upon which progress was made, the editorial positions them as contributors whose injuries, endurance and outcomes shaped the establishment and evolution of surgical practice.

The announcement also arrives at a meaningful moment for the journal itself. BMC Plastic and Reconstructive Surgery is a new open access title, and the history series appears in its first volume, as article number nine. Launching a focus series on the field’s origins in a journal’s inaugural year is a deliberate statement of editorial identity: the journal is positioning historical scholarship not as a peripheral curiosity but as a core strand of the specialty’s literature. The open access model matters here too, since making historical research freely available allows surgeons, students, historians and the public to engage with the field’s past without paywall barriers.

For working surgeons, the editorial suggests that historical knowledge has practical value beyond commemoration. Understanding why a particular flap design, fixation method or reconstructive algorithm emerged, and under what constraints it was first tested, can deepen technical judgment and clarify which elements of current practice are fundamental principles and which are contingent solutions to problems that may no longer exist in the same form. For patients, the history is a reminder that every contemporary standard of care, from burn reconstruction to microsurgical reattachment, was earned through the experiences of people who underwent surgery in eras without modern anesthesia, antibiotics or imaging.

The series now open for submissions invites researchers to document and analyze this heritage in detail, whether through studies of individual surgeons and patients, the evolution of specific techniques and instruments, or the field’s portrayal in art and literature. As the editorial makes clear, the history of plastic and reconstructive surgery is extensive, complex and remarkable in its depth, and the journal intends to ensure that this record, with all of its innovation and all of its human cost, is preserved, examined and made freely available to everyone the specialty serves.

Subject of Research: The history and evolution of plastic and reconstructive surgery from ancient times through modern military-driven innovation

Article Title: History of plastic surgery: introducing a BMC Plastic and Reconstructive Surgery focus series

Article References: Sinelnikov, M. Y. (2025). History of plastic surgery: introducing a BMC Plastic and Reconstructive Surgery focus series. BMC Plastic and Reconstructive Surgery, 1(1), Article 9. https://doi.org/10.1186/s44452-025-00009-1

Image Credits: AI Generated

DOI: 10.1186/s44452-025-00009-1

Keywords: plastic surgery, reconstructive surgery, history of medicine, military surgery, Sushruta, Harold Gillies, Archibald McIndoe, microsurgery, world wars, surgical innovation, open access, BMC Plastic and Reconstructive Surgery

Dr. Bamji’s path to the archive was anything but planned. Trained at the Middlesex Hospital Medical School and qualifying in 1973, he arrived at Queen Mary’s Hospital, Sidcup in 1983 as a consultant rheumatologist, a specialty seemingly far removed from facial reconstruction. When the retired consultant who managed the hospital’s modest archives died, Bamji, a lifelong collector like his father before him, was asked to take over. The turning point came when a New Zealand orofacial surgeon, Sandy McAllister, contacted the hospital out of the blue: he was giving a lecture at the College of Surgeons in London based on the New Zealand section records from Sidcup, which he had stored in boxes in his garage. After listening to the lecture, Bamji asked whether the records could be returned to the hospital that had created them. McAllister later suffered a stroke, and after Bamji wrote to him in New Zealand, his son agreed to send the records back, with the hospital paying the considerable shipping costs. That first recovery yielded around 280 records, together with watercolors painted by New Zealand and Australian artists.

Chance then compounded the discovery. As Director of Medical Education at Sidcup, Bamji received an invitation from the Institute of Medical Illustrators, offered to give a talk on medical illustration in the First World War, and wrote an accompanying article. A month after publication, he was contacted with astonishing news: the entire British section of the First World War records, roughly two and a half thousand files, were sitting in the photographic department of Queen Mary’s Hospital in Roehampton, unknown to the Sidcup staff. Bamji believes Gillies had removed the records from Sidcup to write his book and kept them personally, taking them with him when he moved to Rooksdown House, part of Park Prewett Hospital in Basingstoke, during the Second World War. When Basingstoke closed in 1960, the unit relocated to Roehampton, taking every record from 1914 through 1960 with it. The haul included not only the First World War files but Second World War records as well, among them the first documented case of female-to-male gender confirmation surgery. Faced with an archive nobody else possessed, Bamji set out to write about it; his book, Faces from the Front, took twenty-three years to complete, a process accelerated when his daughter, a historian, demanded a thorough rewrite of his first draft.

The files document a revolution in surgical thinking. As Bamji explains, before Gillies, reconstructive procedures were performed in a haphazard, occasional fashion, guided by textbooks such as that of Nelaton and Ombredanne, which were filled with diagrams of nasal reconstruction but contained no photographs, leaving surgeons no way to judge whether the techniques actually worked. Gillies tested them and found that many did not. One fundamental lesson, Bamji notes, is that a reconstructed nose cannot stand up unless the created structure is supported with soft tissue and a cartilage graft. What made Gillies’s systematic approach possible was the unprecedented scale and variety of facial injury in the First World War, a conflict in which, uniquely for its time, many soldiers survived wounds and disease that would have killed them in earlier wars, producing thousands of disfigured patients who required sustained reconstructive care.

Equally important to Bamji’s work is the second story the archive tells: that of the patients themselves. While much scholarship has focused on surgical innovation, Bamji investigated the psychology of facial injury, testing the widespread assumption that these men hid from society, could not work and lived in misery. The archives revealed a different reality. Many patients disliked their disability and refused to be photographed on the affected side, yet they held down jobs, married, had children and became loving grandparents. Bamji’s focus on patients’ lives was made possible by Gillies’s own approach, which Bamji describes as a complete change of surgical direction: instead of the authoritative old model in which surgeons simply told patients what would happen, Gillies asked whether a proposed plan appealed to them and built a multidisciplinary team of surgeon, dentist, technician, anesthetist, artist, photographer, nurses and occupational therapists, with the patient as a genuine member of the team. That personalized philosophy, now standard in plastic surgery, and Gillies’s meticulous recordkeeping together created a resource that lets modern readers watch procedures evolve through trial, error and refinement.

Art was central to that recordkeeping. Black-and-white photography alone could not convey what Gillies needed to document, so he employed illustrators including Henry Tonks, a former surgeon; Daryl Lindsay, who had once worked as a ranger on an Australian farm; and Herbert Cole, an artist in the New Zealand Army Medical Corps who was drafted to Sidcup once his talent was discovered. Gillies insisted that color was indispensable: in burns cases, he argued, one must understand the lividity of a burned scar, which no photograph could recreate. The watercolors in the archive capture skin necrosis, perfusion complications, bruising, infection-related discoloration and ischemic signs, visual information that, combined with Gillies’s extensive experience, helped establish now well-known rules of flap management that remain embedded in surgical training.

The conversation also turns to the ethics of publishing patients’ stories. Bamji decided to use patients’ names in his book because every relative he contacted welcomed the recognition, asking why wounded veterans of these pioneering procedures should be less visible than the war dead honored on television. He notes a revealing contrast: in Gillies’s second book, The Principles and Art of Plastic Surgery of 1957, patient details in the gender confirmation section were altered because, after the founding of the National Health Service in 1948, rules prohibited access to medical notes, extending a restriction long applied to psychiatric records. For the First World War files, however, the stories and the families’ wishes permitted openness, and Bamji argues that honoring these patients is essential to teaching new generations of surgeons where today’s seemingly obvious surgical rules came from. If you do not tell the story, he says, nobody can understand it.

The human cost of the work, for surgeons and archivists alike, receives careful attention. Bamji recalls that early in his research he could not examine more than about 30 case files at a time before the imagery became unbearable, yet over years of review he found the technical medicine gradually taking over from the person behind each wound, a coping mechanism he compares to that of frontline surgeons. He stresses that empathy must survive this adaptation, echoing Gillies’s near-indefinite follow-up of patients, including a man he encountered in Australia thirty years after surgery, to whom Gillies declared he had not finished with him; the patient firmly disagreed. The archive also preserves remarkable documents of surgical accountability, such as Thomas Pomfret Kilner’s letter to the family of a patient who died of a cerebral abscess, explaining what went wrong, apologizing and offering help with the pension. Bamji recounts the tragic case of Henry Ralph Lamley, who survived severe burns only to die months later as a consequence of a plastic operation, a loss that prompted Gillies’s remorse and his principle: never do today what can honorably be put off until tomorrow. Such tragedies, Bamji argues, shaped the specialty’s standards and belong in medical education, alongside training in empathetic communication with grieving relatives, a lesson he instilled through role-play with his own students.

The discussion closes with reflections that range across artificial intelligence, peer review, academic publishing and healthcare systems, converging on Bamji’s conviction that medical history deserves a central place in training. Asked what advice he would give students entering medicine, he offers a distillation of both his clinical career and his archival one: think before you do, look back at history, ask whether someone has encountered the problem before, keep up to date with medical advances, examine research critically, beware of becoming tied to the pharmaceutical industry, and always examine the patient. It is advice that resonates with Gillies’s own late reflections, written in longing for the New Zealand bush, the tūī, painting and a few holes of golf, a reminder that medicine is ultimately a path chosen by those who want to help others with their knowledge, empathy and compassion, and that the surgical rules considered obvious today were written, painfully and painstakingly, by the patients and surgeons of Sidcup.

Subject of Research: Historical origins of plastic and reconstructive surgery based on the Gillies Archives of First World War surgical case files

Article Title: The origins of plastic and reconstructive surgery: a discussion with Dr. Andrew Bamji

Article References: Sinelnikov, M., & Bamji, A. (2026). The origins of plastic and reconstructive surgery: a discussion with Dr. Andrew Bamji. BMC Plastic and Reconstructive Surgery, 2(1), Article 12. https://doi.org/10.1186/s44452-026-00025-9

Image Credits: AI Generated

DOI: 10.1186/s44452-026-00025-9

Keywords: Harold Gillies, plastic surgery, reconstructive surgery, Gillies Archives, Queen Mary's Hospital Sidcup, First World War, facial injury, medical history, medical illustration, patient psychology, multidisciplinary team, Andrew Bamji