Royal Belgian Society

Prof P. Wylock

Editorial of Prof P. Wylock, Past President of the Royal Belgian Society for Plastic, Reconstructive and Aesthetic Surgery

Modern plastic surgery blossomed during World War I in order to give the large number of soldiers who suffered facial mutilations, ‘les gueules cassees’, another chance at a dignified existence thanks to reconstructive operations. At that time the work of famous predecessors such as Gillies, Morestin and Esser was not overlooked.

During the period between the two world wars there was a proliferation of certified and uncertified surgeons that focused chiefly on cosmetic surgery. Such famous people as the French actress Sarah Bernhardt took advantage of cosmetic assistance, having no qualms about making this ‘repair work’ extensively known via the media. This, too, resulted in a boom in the realm of cosmetic surgery.

World War II temporarily put an end to this luxury surgery.

During World War II the reconstructive aspect of our profession once more came into the spotlight. Over the course of time scientific associations of plastic, reconstructive and aesthetic surgery were established in many countries.

In Belgium it was not until 1955 that our association was established by such people as Dr. Coelst, the first plastic surgeon in Belgium.

This year, on May 5 and 6, we celebrated our 50th anniversary with suitable pomp in the Cinquantenaire in Brussels. On that occasion our association received the designation "Royal".

Nor did the publication of the Commemorative Anniversary Book pass without notice.

One of the things we did to mark the celebration was to hand out a charter (that can be read at our site ( click on “Cosmetic Code of the rbsps”) about the situations of malpractice in the field of cosmetic surgery. Our opinion, after all, is that our work is a matter of professional honour.

The press paid significant attention to this.

In the last decade and to the present day, cosmetic surgery has been very popular once again, just as it was during the interbellum. Qualified (and unqualified) physicians have discovered the lucrative facet of this branch of plastic surgery. Today, too, many well-known people undergo cosmetic surgery and report on this in detail via the media. History keeps repeating itself.

We have all sworn the Hippocratic Oath after our medical studies, nowadays the Oath of Geneva, but for many colleagues this has become an irrelevant idea, once they have started up a ‘plastic’ practice.

At the beginning most younger colleagues are interested in the reconstructive aspects of our profession, microsurgery, hand surgery, but... once they are licensed, after years and years of training, their interest above all switches to the more lucrative field of cosmetic surgery. The ‘editorial’ of L. Furlow in the PRS of December 2004 “Plasmetic Surgery”[1] hits the nail on the head.

Full-time academic staff positions in plastic surgery are no longer sought after, because the remuneration at private hospitals is much higher than it is at university medical centres.
We have now reached the point where it becomes difficult to fill academic positions in plastic surgery.

"Can academic plastic surgery survive?" asked the American R. Ruberg in 2004 [2].

I doubt it.

But I don’t want to be too pessimistic. Never before have our reconstructive techniques been as refined as they are today. Never before has so much been published in the many journals of plastic surgery. Never before have so many extremely interesting books been written in our area of expertise. Our profession is witness to a great amount of creativity in the realm of surgery.

We are on the brink of exciting evolutions. Tissue engineering is in its beginning phase...and we will hear a great amount about the many realms of applications of stem cells in the future.

May I recommend that we above all continue to be ‘healers’, this is our vocation, this is our challenge. After all, we don’t want to see our profession degenerate into nothing more than a profitable business, do we?

Prof. Paul Wylock,

Past President of the Royal Belgian Society for Plastic, Reconstructive and Aesthetic Surgery.

1. Plasmetic Surgery,
L. T. Furlow, Plastic and Reconstructive Surgery, 2004, 114, 1954-1958
2. Can academic plastic surgery survive?
R. Ruberg, Annals of Plastic Surgery, 2004, 52, 329-330