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information spread. Nevertheless, conflicts between plastic surgeons and regional plastic surgeons increased and found their way into the popular media and press.l-' As a result of the public denigration of regional plastic surgeons, plastic and reconstructive surgery was clearly established as an integral component of otolaryngology education, practice, and board certification.' Indeed, until the early 1960s, organized plastic surgery in the United States was openly hostile to the public practice of cosmetic surgery and, as a result, to education in this field. That decade, however, saw an important turning point with the Dalinde seminar on cosmetic surgery in Mexico City, organized by Mario Gonzalez-Ulloa. The activities of their colleagues in Mexico made plastic surgeons in the United States recognize the growing importance of cosmetic surgery and the need for education and communication.v' In hopes of providing one voice for cosmetic surgery, negotiations began between Fomon's American Otolaryngologic Society of Plastic Surgery, Goldman's Society of Facial Plastic Surgery, and Cottle's American Rhinologic Society. In 1963, Richard Webster, later known as "the father of American cosmetic surgery," attended an informal meeting of members of the 3 nasal societies. Webster describes his reaction as follows: "For the first time in my life, I met man after man who honestly, without any shame at all, evinced a paramount interest in what I considered my field, cosmetic surgery. "3(pl2) On October 18, 1964, the American Otolaryngologic Society of Plastic Surgery and the Society of Facial Plastic Surgery united to form the American Academy of Facial Plastic and Reconstructive Surgery.' The Academy was open to physicians of all disciplines and its major activity was postgraduate education. Cottle did not allow the American Rhinological Society to join the new academy." It is conjectured that he would not be part of an organization that emphasized cosmetics over function. By the end of the 1960s, the foundations for a true specialty of cosmetic surgery had been laid. The first American cosmetic surgery educational program was held by the American Academy of Facial Plastic Surgery at Cook County Hospital in Chicago in 1968. In 1969, under the direction of Richard Webster, the Facial Plastic Academy held its first course on aging faces at Tulane University in New Orleans. Webster assessed the importance of this event by saying, "This 112 was the first course given in which the regional or systemic specialist was exposed to subjects that might be thought of as not in his field at all, unless his field had become, in truth, cosmetic surgery.":' This meeting represented a multidisciplinary exchange of ideas between different specialists on the common topic of cosmetic surgery. In 1967, 2 plastic surgeons, Simon Fredricks of Houston and John Lewis of Atlanta, met and discovered that they both felt separate from the mainstream of plastic surgery. They and their colleagues could not get the podium at plastic surgery meetings, and there was no sharing of ideas or communication of techniques in the area of cosmetic surgery. According to Fredricks, "It was almost impossible to be able to give a paper on aesthetic surgery." \(p63A) The pair organized the American Society of Aesthetic Plastic Surgery in 1967, with Webster as the historian. The first meeting was planned for February 1969. The majority of ASPRS members considered the founders of the Aesthetic Society to be a "not so loyal opposition." I(p64A) Webster had told the organizers of the American Society of Aesthetic Plastic Surgery that a similar organization had been proposed by members of the American Academy of Facial Plastic and Reconstructive Surgery and that it would be open to men from all disciplines, including plastic surgeons interested in cosmetic surgery. Webster was convinced to urge his non-plastic surgeon colleagues to postpone their society. He was told that no plastic surgeon would join the other group, but that the American Society of Aesthetic Plastic Surgery would invite reputable cosmetic surgeons from other disciplines to join so that it could represent all of the field of cosmetic surgery. After the first meeting of the American Society of Aesthetic Plastic Surgery, Webster was told that the invitation to non-plastic surgeons would need to be delayed due to the hostility toward the new society from plastic surgeons themselves.' In May 1969, the American Association of Cosmetic Surgeons was incorporated by the original study group that had traveled from city to city to learn each other's rhinoplasty and facial plastic techniques. Its founders decided not to activate the association and to wait for the promised invitations from the aesthetic plastic surgeons. Five years later, the invitations never materialized, and active meetings of the American Association of Cosmetic Surgeons began in 1974. Membership of this group included ophthalmologists, plastic surgeons, dermatologists, otolaryngologists, general surgeons, and physicians from other fields.' On March 19, 1979, Richard Aronsohn, a Los Angeles otolaryngologist, and Robert Franklin, a Los Angeles plastic surgeon, incorporated the American Board of Cosmetic Surgery in Delaware. These men had devoted their practices and careers to cosmetic surgery and recognized the interdisciplinary nature of the
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