Pioneers of plastic surgery: the story of Kiwi innovation over the war years (Part 3)

The story of New Zealand’s extraordinary influence on the evolution of plastic and maxillofacial surgery is one of innovation forged in adversity.

Pioneers of plastic surgery: the story of Kiwi innovation over the war years (Part 3)
Guinea Pig Club Roll of Honour Board, Imperial War Museums, UK. Reproduced with permission from Queen Victoria Hospital (WMR-72952).

Read Part 1 about pioneers of plastic surgery here, and Part 2 here.

Master surgeon and mentor: Arthur Mowlem

Building on the groundbreaking work of Harold Gillies, Archibald McIndoe, and Henry Pickerill, a new generation of surgeons emerged to carry the specialty forward. Among them was Arthur Rainsford Mowlem (1902–1986)—another New Zealand-born surgeon whose career would see him become a key figure in the advancement and teaching of plastic and reconstructive surgery in Britain.

Like many New Zealand-trained surgeons of his era, Mowlem was a graduate of the University of Otago, and travelled to the United Kingdom for further study. While acting as a locum at Hammersmith Hospital, Mowlem cared for patients of the renowned plastic surgeon Sir Harold Gillies. Recognising his talent, Gillies invited Mowlem to join him and fellow surgeon McIndoe at St James Hospital, Balham—the first public plastic surgery unit in the UK. Mowlem remained by Gillies’ side for two formative years, entering private practice with Gillies and McIndoe. By the time WWII erupted, Mowlem had become one of the field’s leading figures—one of the “big four” of early plastic surgery.

During the war, Mowlem treated countless victims of air raids and took part in some of the earliest clinical trials of penicillin. Under his leadership, the plastic and maxillofacial unit at Hill End Hospital in St Albans evolved into a respected wartime teaching centre, training a new generation of surgeons in the complex and creative discipline of reconstructive surgery.

After the war, Mowlem continued to shape the future of the field. He served as an adviser in plastic surgery to the Ministry of Health and became a driving force behind the formation of the British Association of Plastic Surgeons. His primary clinical focus was on reconstructive procedures following cancer treatment. Perhaps most remembered for his skill as a teacher, Mowlem passed on both his knowledge and his passion, leaving a lasting legacy in surgical education and practice.

The story of New Zealand’s extraordinary influence on the evolution of plastic and maxillofacial surgery is one of innovation forged in adversity. Across two world wars, the groundbreaking work of this small group of New Zealanders, developed on the battlefields and in wartime hospitals, not only redefined surgical practice but also laid the foundation for a new medical specialty.
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Tube pedicle flap repair to face by Sir William Manchester. Image courtesy of the Sir William and Lady Lois Manchester Charitable Trust and Dr Earle Brown.

Advancing upper-limb reconstruction: John Barron

Following in the footsteps of Gillies, McIndoe, Pickerill, and Mowlem, yet carving out a specialty of his own, John Barron (1911–1992) was another University of Otago graduate whose career would have a lasting impact on the field of reconstructive surgery. Like many of his fellow New Zealanders, Barron headed to the UK after earning his medical degree in 1936, joining a distinguished lineage of Kiwi surgeons who helped shape plastic surgery during the 20th century.

Barron trained under two of the field’s giants— Mowlem at Hill End Hospital in St Albans and Gillies at Rookstown House Hospital in Basingstoke. During WWII, he developed a particular interest in the complex challenges of hand and upper-limb injuries. In 1945, his expertise earned him a place leading a British surgical team to Yugoslavia, where he helped establish a 120-bed reconstructive surgery hospital in Belgrade. That mission sparked a lifelong bond with the country; Barron returned nearly every year to lecture, mentor, and support the surgeons he had trained.

In 1949, Barron became the founding director of the Wessex Regional Plastic and Maxillo-Facial Unit at Odstock Hospital in Salisbury, England, a facility originally built by American forces during the war. Under his leadership, the hospital gained an international reputation for excellence in reconstructive surgery, particularly in upper-limb work. Barron’s commitment to surgical innovation attracted trainees from around the world, further extending the global influence of New Zealand's remarkable legacy in plastic surgery.

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Sir William Manchester’s skin grafting knife.The fixation device to fix the distance between roller and blade to control the thickness of the graft. Image courtesy of John Williams.

A trailblazing force: Sir William Manchester

From rural beginnings in Waimate, Canterbury to international success and recognition as a surgeon, Sir William Maxwell Manchester (1913-2001) was a trailblazing force in the field of plastic surgery in Aotearoa New Zealand. His substantial international contributions to his field including his surgical expertise, advancement of the art and science of cleft lip and palate surgery, establishment of New Zealand's first three plastic surgery units, and far-sighted best practice contributions to global plastic surgery paved the way for the crucial development of plastic surgery in the country.

Combining advanced surgical techniques and the concept of ‘pre-surgical orthopaedics’, the management of cleft lips and palates in New Zealand made major advances under Manchester’s leadership. Manchester obtained international recognition for his expertise and innovation in treating children with cleft lip and palate, and his special skill in mandibular reconstruction using large free bone grafts. After establishing the plastic surgery unit at Middlemore Hospital, Manchester went on to train generations of young surgeons and nurses, leaving a considerable legacy in this field.

Read more about Sir William Manchester’s significant contribution to plastic surgery here.

Innovation forged in adversity

The story of New Zealand’s extraordinary influence on the evolution of plastic and maxillofacial surgery is one of innovation forged in adversity. Across two world wars, the groundbreaking work of this small group of New Zealanders, developed on the battlefields and in wartime hospitals, not only redefined surgical practice but also laid the foundation for a new medical specialty.

The post-WWII establishment of Regional Plastic Surgery Units in New Zealand mirrored the integrated model pioneered by Gillies, McIndoe, and Mowlem, combining surgical precision with dental and rehabilitative care. The influence of these early pioneers continues to shape plastic surgery today; an enduring Kiwi contribution to global medicine.

Read Part 1 about pioneers of plastic surgery here.

Read Part 2 here.

Dr Earle Brown FRACS FRCS is a well-known plastic surgeon who, before retiring from practice in Aotearoa New Zealand, played a role in the development of plastic surgery in our country. He is the former Head of Unit and Consultant Plastic Surgeon, Middlemore Hospital, New Zealand.

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Find out more about the history of plastic surgery.

Read about New Zealand’s contribution to plastic surgery and the origins of the word ‘Plastic’.

Read about Sir William Manchester’s role in the establishment of plastic surgery in New Zealand.

Discover the work of Sister Joyce Walters in the establishment of the New Zealand plastic surgical nursing service.

Skin deep: unveil the secret superpowers of your body’s largest organ.

Planning is of the essence: read Part 1, Part 2, and Part 3 of a summary of reconstructive surgery techniques.

Find out about war photography of plastic surgery: read Sandy Callister’s article, ‘Broken Gargoyles’: The Photographic Representation of Severely Wounded New Zealand Soldiers in Social History of Medicine Vol. 20, No. 1 pp. 111–130.