To be able to replace a damaged organ has been an eternal dream for every physician. Primitive man established a clear difference between the many pathological processes to which he is a victim. On one hand, he attributed the internal affections to malefic influences of supernatural beings or to divine punishments; on the other hand, the external affections were object of specific treatments which constituted the basis for early surgical knowledge.

These first surgeons were surrounded by a magical halo, because it was believed that their activities were inspired by divinity. A long time passed before the distinction between medicine and religion was produced. Surgeons understand that their profession is more than simple manual operations; they study healthy human beings in order to better understand the sick, comparing anatomically and pathologically. They collaborate with chemists and physicists creating experimental surgery, they constitute scientific societies and publish specialized journals. Thus medicine is awakened, paralyzed only by routine and dogmatism.

By definition, to reconstruct is to construct once more. This is what is ideally sought by reconstructive surgery: to reconstruct the lost or affected anatomic area. In a strict sense, it is not possible to invent the lost tissues even though we are very near in reaching such a task.

Bone, skin and other tissues can be auto grafted  (taken from one area of the body and then implanted at another site). Already in ancient India Sushruta applied a skin grafting technique after the loss of a nose. Tagliacozzi improved this technique by temporarily attaching a portion of skin from the arm into the damaged area in order to reconstruct the face.

As has happened in other surgical specialties, reconstructive surgery was originated by the effort of a small group of medical enthusiasts who using a particularly refined technique, soon established the surgical basis for surgery in a particular area. Afterwards, these techniques were modified by others, in the limitless field of this specialty.

This is why in 1869, for example, Guyon described in Paris how he had taken small fragments of skin in order to repair a wound. With wars, came burn patients. Their treatment and rehabilitation were eternal and soon it was learned how to avoid their death. Later it was learned how to treat their wounds and finally how to solve their secuelae.

In this so called “Surgery of War”, hand surgery was greatly developed, rehabilitating thousands of patients with the repair of very serious wounds of different origin. Bone grafts were popularly used to repair seriously damaged areas of the human skeleton.
 

Reconstructive surgery has evolved greatly. Today it involves:
 
 

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In this manner, plastic surgeons are no longer exclusive authorities of a specific area, in a class by themselves; they are now considered expert mentors and efficient collaborators.