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otolaryngological plastic surgery society for the next 2 decades. During the 1950s, the number of otolaryngologists seeking to learn nasal surgery increased. Two menMaurice Cottle and Irving B. Goldman-stand out as the primary teachers of nasal surgery in the 1950s and 1960s. In Chicago, Cottle emphasized functional nasal surgery. His first instructional course took place in 1949. The American Rhinologic Society was founded by his supporters in 1954.2 In New York, Goldman developed an interest in rhinoplasty through his friendship with the plastic surgeon, Joseph Safian. Goldman studied in Europe and was a student of the Fomon Course. During the 1940s, he developed a flourishing practice that included many well-known show business personalities." In 1950, Goldman began a formal teaching course on rhinoplasty that he personally taught until 1969. In contrast to Cottle's emphasis on functional surgery, Goldman's emphasis was on cosmetic rhinoplasty. The tradition of the Goldman course continues today with the annual Mount Sinai Hospital rhinoplasty course. Just as Fomon and Cottle had inspired societies, Goldman and his students founded the American Facial Plastic Surgery Society in 1953. This group continued until 1964. 2 It must be emphasized that the progress described in the preceding paragraphs occurred only because a number of individuals put the advancement of medical technique and the diffusion of medical knowledge ahead of rivalries with competing medical specialties. They faced formidable opposition, however. In 1921, at the same time that Maliniac, Aufricht, and Safian were studying with Joseph in Berlin, the American Association of Oral and Plastic Surgeons was founded in Chicago.' Membership was limited to surgeons with The American Journal of Cosmetic Surgery Vol. 16, No.2, 1999 both medical and dental degrees. The requirement for a dental degree was dropped in 1923, as was the word "oral" in 1942. The American Association of Plastic Surgeons that we know of today was established, 1 but surgeons who openly performed cosmetic surgery were not included within the select membership of the Association. Among the surgeons not offered membership in the American Association of Oral and Plastic Surgeons were Maliniac and Aufricht. Ma1iniac went on to lay the foundation for a society that "would be an open forum for all engaged in the ethical practice of plastic and reconstructive surgery. "l(pl4A) It would be a source of information for members of other specialties interested in plastic surgery problems. It is reported that Maliniac sought the support of representatives of related fields such as anesthesiology, dermatology, radiology, and otolaryngology.' Maliniac's original society, organized in 1931, had an allied membership category. Aufricht criticized Maliniac's group as "consisting mostly of borderline specialists such as eye surgeons, otolaryngologists, oral surgeons, and dermatologists." l(pl5A) This organization, the American Society of Plastic and Reconstructive Surgeons (ASPRS), grew during the 1930sand held both regional and annual meetings for the exchange of ideas. Presentations on cosmetic, or aesthetic, surgery were rare, and they were usually presented by Aufricht on the topic of rhinoplasty. 1 From 1937 to 1944, all of the presidents of the American Society of Plastic and Reconstructive Surgery had been previously certified by the American Board of Otolaryngology. The most recent written history of the American Society of Plastic and Reconstructive Surgery clearly defines the scope and the attitude of plastic surgeons during the 1930s: "Legitimate plastic surgery was considered reconstructive surgery and largely limited to helping patients with congenital defects." Although Maliniac, Aufricht, and others 'bobbed noses' and performed some breast operations, such procedures were not considered mainstream."l(p18A) Some aesthetic procedures were carried out by "legitimate plastic surgeons," but such work occurred quietly, without fanfare. Most plastic surgeons yearned to be recognized as "serious surgeons" and avoided what were considered frivolous procedures. ' Richard C. Webster, a board-certified plastic surgeon and first president of the American Academy of Cosmetic Surgery, reported that when he began his practice in 1947, the message was crystal clear: "Reconstruction is in, cosmetic is out. "3(p8) Indeed, for a time, as plastic surgery became established as a surgical specialty in the United States, the exchange of ideas between disciplines decreased rather than increased. Operating room doors were closed, hospital privileges were blocked, and meetings were closed to nonmembers.' With the establishment of a board and a society, many of the founders soon abandoned their original discipline and forgot that their 111 skills and knowledge had a basis in their original training and experience. As a result, many of the advancements and refinements in cosmetic surgery techniques arose through the creation of informal study groups. A small group of surgeons would travel to observe a colleague operate, then gather to analyze, criticize, and discuss the surgical procedures. This group included Benito B. Rish, Maury Parkes, Jesse Fuchs, Ira Tresley, Oscar Becket, Richard Farrier, Jack Anderson, John Dickinson, and William Wright. Knowledge increased and
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