Table of Contents
It was time for mainstream otolaryngology to take notice. Certainly the general plastic surgeons had. An aggressive campaign to disparage facial plastic surgeons culminated in a Harper’s Bazaar article in 1960, which for the first time told the public to protect itself from otolaryngologists who claimed to be qualified to perform nasal plastics: “Be sure your surgeon has the added years of study and experience which the American Board of Plastic Surgery certification guarantees… ask a surgeon point blank to see his board certification…” the article said.
The claim caused an uproar, with facial plastic surgeons asking the American Medical Association to censure the general plastic surgeons for unethical behavior. When the AMA did not, it was felt that facial plastic surgeons had too much the reputation of rebels, and facial plastic surgeons appealed to otolaryngology for support. In a historic meeting at Chicago’s Palmer House in 1961, Anderson presented a collection of fifteen years worth of “crassly commercial” statements published by the general plastic surgeons, each subtly defaming the ability of otolaryngologists to perform facial plastic surgery. His evidence convinced otolaryngology (then represented by the American Academy of Otolaryngology and Ophthalmology) to ask the Advisory Board of Medical Specialties (the precursor of the American Board of Medical Specialties) to reprimand the ABPS. Although the ABMS did so, the effect was negligible, because the American Society of Plastic and Reconstructive Surgery later took up the defamation campaign. The truly historic aspect of these events, however, was that otolaryngology officially noticed and supported its facial plastic surgeons.
Not long afterward, in 1963, Lierle took aside a prominent otolaryngologist, Joseph Goldman, who was then chief of otolaryngology at Mt. Sinai Hospital, chairman of the ear, nose, and throat section of the AMA, and a political force in his own right and advised him to organize facial plastic surgeons into one society. Future support from otolaryngology would be easier to obtain this way, he said. At the time, there were three societies, each formed by the loyal followers of Foman, Cottle, and Goldman. After much negotiation, the terms of amalgamation were agreed upon. Although the Cottle society (the American Rhinologic Society) at the last minute chose to remain separate, on October 18, 1964, the Foman and Goldman groups merged into a new society named the American Academy of Facial Plastic and Reconstructive Surgery. Incorporation of the society was arranged in New Jersey by Irvin J. Fine, who would serve as the groups first treasurer. The main goals of the AAFPRS were remarkably similar to those steadfastly pursued by facial plastic surgeons since the twenties: to continue developing training opportunities and to win recognition for their expertise.
To achieve these goals, AAFPRS had to negotiate its way through some turbulent waters. A major question was: Would it be better to work within otolaryngology, which had withheld its endorsement for so many years, or to go it alone? This question had no easy answer, because otolaryngology had been undergoing its own identity crisis since the end of World War II. Certainly otolaryngology was no longer a specialty of the ears, nose, and throat. Its focus increasingly was on head and neck surgery, but the identity of otolaryngology as one specialty seemed in doubt. The field had broken into many small specialties – bronchology, esophagology, facial plastic and reconstructive surgery, head and neck surgery, laryngology, otology, rhinology, and more – and every branch of the specialty had its own academic society. In the mid-sixties, the AAFPRS was one of a dozen or more otolaryngology groups, each with its subspecialty interest. None could claim to speak for one and all. The venerable AAOO had an esteemed educational presence, but the socio- political-economic concerns of otolaryngologists lacked leadership. Each group keenly felt the lack of a unified voice, and felt that it independently had to defend the specialty’s expansion into head and neck surgery.
The result was that the AAFPRS pressed forward to achieve its own goals, while simultaneously joining with the other special-interest otolaryngological groups to sponsor a new national society that would give one voice to otolaryngology. That society, the American Council of Otolaryngology, was formed in 1968 and went through several transformations before emerging in 1982 as the present-day American Academy of Otolaryngology-Head and Neck Surgery.