From a stab wound to a surgical specialty: a narrative review of the historical development of plastic and reconstructive surgery in Korea, 1884–2026

Abstract Background South Korea’s transformation from having no plastic and reconstructive surgery capability in 1945 to becoming the global leader in aesthetic procedures per capita represents one of medicine’s most remarkable national development stories. No comprehensive historical review tracing the specialty’s complete trajectory has been published. Main text This narrative review examines the origins, key figures, institutional developments, and evolutionary trajectory of plastic and reconstructive surgery in Korea from 1884 to 2026 through historiographical analysis of primary sources including society archives, founding surgeons’ memoirs, wartime medical records, and institutional histories. Western surgery in Korea originated on December 4, 1884, when Horace Allen treated the stab wounds of Min Young-ik following the Gapsin Coup, leading to the establishment of Korea’s first Western hospital. The Korean War catalyzed the specialty’s development; D. Ralph Millard Jr. developed his globally adopted rotation-advancement flap for cleft lip repair while operating on Korean children. Lew Jae-duk obtained American Board certification and founded the first plastic and reconstructive surgery department at Yonsei University in 1961. His disciples and independently trained pioneers subsequently established departments nationwide. The specialty evolved through five distinct phases: wartime introduction (1945–1960 s), institutional foundation (1966–1975), technical specialization (1975–1985), aesthetic emergence (1985–2000), and internationalization (2000–present). Conclusions By 2026, over 2,800 specialists had been certified and the Korean Society of Plastic and Reconstructive Surgeons had grown into the world’s third-largest national plastic surgery society. The trajectory from improvised wartime care to global prominence illustrates how historical contingency, individual initiative, and socioeconomic forces shape a specialty’s development, and the reconstructive mission that defined the specialty’s emergence continues to require careful stewardship by those who inherit it.