Sir Harold Gillies: The Modern Father of Plastic Surgery

For Gillies, plastic surgery not only involved restoring function but also making the person look normal and sometimes more beautiful than before. He was driven by the idea that the surgeon should be creative, imaginative—in fact, an artist.1 —C.J. Williams Dr. Harold Gillies is widely regarded as the modern father of plastic surgery and his contributions to the specialty were foundational. Gillies was a pioneer of innumerable procedures that continue to be used today, including the tubed pedicle flap and female-to-male gender affirmation surgery.2 Harold Gillies was born on June 17, 1882, in Dunedin, New Zealand.2 He studied medicine at Gonville and Caius College in Cambridge and completed his clinical training in London.2 Although Gillies specialized in ear, nose, and throat surgery, his career path quickly deviated during World War I.2,3 Through his experience with the Red Cross and dentist Auguste Valadier in France, as well as his surgical observership of Hippolyte Morestin, he developed a keen interest in facial reconstructive surgery.2 Gillies brought his experience back to England, opening a facial reconstruction unit in Aldershot in 1915, then his second in 1917 in Sidcup once the first unit became overloaded with war casualties.2 Sidcup became an important teaching base, concentrating highly technical cases with the world’s finest surgeons.2 Based on his key contributions, Dr. Gillies was knighted in 1930.2 Dr. Gillies pushed the limits of plastic surgery through his innovation and development of novel surgical techniques. He pioneered procedures, such as the nasal inlay graft,3 amputated digit autograft,4 fan flap,3 forehead flap variations,3 phalloplasty,2 and temporalis transfer,2 and was an important contributor to the tubed pedicle flap,2 face lift,1 and mammaplasty.1 Throughout his career, Gillies was an avid educator and played a major role in developing multidisciplinary medical teams, involving artists, sculptors, and photographers to assist in case planning and documentation.2 He also worked closely with other physicians, including anesthesiologists Rubens Wade and Ivan Magill, who pioneered crucial advances in surgical anesthesia.2 Beyond his technical skillset, Dr. Gillies was a strong advocate for his patients, even when his surgeries were not yet socially accepted. Most notably, he performed the world’s first phalloplasty against UK legislature, a practice that ultimately advanced the field toward greater inclusivity.1,2,4 To address the extensive facial injuries sustained by soldiers in World War I, Dr. Gilles was a key contributor to developing the technique using pedicled and tubed flaps to restore facial form and function. This facilitated the integration of injured soldiers back into their communities but also set the foundation for more complex reconstructive techniques that became the standard surgical techniques used in gender-affirming procedures, head and neck reconstruction, and breast surgery. Dr. Gillies was a pivotal advocate for multidisciplinary, patient-centered teams, which would only decades later be recognized as the standard of care. He died in 1960,5 but his legacy within the field of plastic surgery will continue to inspire new generations of surgeons. DISCLOSURE The authors declare that their study was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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