America's fertile frontier: how America surpassed Britain in the development and growth of plastic surgery during the interwar years of 1920-1940.

Most historians agree that modern plastic surgery was born out of the efforts of reconstructive surgeons in World War I (WW I). In a single British hospital, over 8000 wounded soldiers were treated for disfiguring facial wounds. These gruesome injuries provided surgeons with enough cases to make unprecedented advances in tissue reconstruction. After the war, however, surgeons returned to civilian society where they found relatively few cases to support their new niche. In England, plastic surgery failed to establish itself while, in the United States, plastic surgeons had much greater success in founding their new specialty. Emphasizing this trend is the staggering statistic that, at the outbreak of World War II (WW II), the US boasted 60 trained plastic surgeons compared with only 4 in Britain. This article analyzes a variety of primary sources (speeches, journal articles, letters, and live interviews) obtained from several libraries and special collections to argue that the relative success of US plastic surgery in the interwar period (1920-1940) can be attributed to (1) the efforts of pioneering American plastic surgeons (Varaztad Kazanjian, Vilray Blair, and John Davis), (2) the post-Flexner report restructuring of US medical training, and (3) a much warmer reception both by the US public and general surgical community to plastic surgery.