Past. Present. Future?

Plastic, Reconstructive and Aesthetic Surgery, it rolls off the tongue and we savour the concepts and wonder a little about what it means. How has Plastic Surgery come to this? A surgical speciality defined neither by anatomy, age or technique; encompassing and embracing change and indulging in not a little introspection. Over the past quarter of a century, I have heard confident predictions of the irrevocable loss of ‘ownership’ of expertise, the dissolution of units, the ultimate demise of the speciality. And yet we not only are surviving but going from strength to strength. More than any other surgical speciality, PRAS is concerned with quality of life. As social, political and economic developments continue to have positive effects on global life expectancy; as scientific, medical and surgical techniques evolve to prevent, ablate and cure malignant and other debilitating disease so the focus on quality of life is ever increasing.

We deal with congenital absence and deformity; we deal with repair and reconstruction after trauma and ablation of tumour; we facilitate subtle and not so subtle change in contour, skin texture, size and appearance of adults who are not so happy with the effects of nature; we have contributed to the increased survival of patients with massive burns and the return to functional independence of victims of complex military and civil trauma.

We have the most sophisticated understanding of functional anatomy of skin and soft tissues of any surgical speciality. We employ a wide range of skills, materials and processes and incorporate into our quotidian practice an ever increasing understanding of fundamental biological processes such as wound healing and matrix remodelling. We are involved in the clinical application of molecular biology but also the biology of molecules. The Plastic surgical community has brought surgery the concepts of immunology, the realities of transplantation, the clinical applications of tissue engineering and now? Plastic, derived from the Greek ‘plastikos’ was previously attributed to the malleable nature of the skin but in the twenty-first century the ‘Plastic’ in our speciality could be equally applicable to another ‘plasticity’ referring to the differential potential of stem cells. This is the super-highway to regeneration and for all Plastic, Reconstructive and Aesthetic surgeons, regeneration must be the most fascinating biological concept of all.

So what is the role of JPRAS in the evolution of our speciality? An international journal which is a source of inspiration, education, entertainment. It gives reassurance; it is a wise friend; promotes discussion and debate and accompanies each and every one of us through our professional lives and beyond. It helps to build bridges between specialties and extend networks. JPRAS is an organ, not a ‘tissue’. We aspire to be multifunctional and find a place in libraries and laboratories, in clinics and class rooms, in offices and operating theatres, in hearts and homes. There is no doubt that as the journal continues to evolve that change is inevitable but the aim will be for subtle change. We pay tribute to Simon Kay, our previous editor who opened up the International platform for the Journal, and now I am delighted and honoured to have the privilege of continuing the journey. I am fortunate to have an extremely talented Editorial team, with Stefan Hofer in Toronto, Henk Giele in Oxford, Ardy Bayat in Manchester and Andy Hart in New Zealand. Behind us is one of the world's greatest publishing houses, Elsevier and our publisher, Chris Hammond, our editorial assistant Annette Fowler, production manager Alison Collett, marketing manager Gaynor Jones and Bethan Keall in Sales and Advertising. We look forward to working with Elsevier to harness their resource to increase the multifunctionality of the journal but also we will seek to challenge, constructively, their formularic approach so that we can create a unique journal that makes a statement and defines the cutting edge of information dissemination in our dynamic speciality. We humbly acknowledge that we are where we are today because of the great visionaries of the past but the future is now in our hands and there is no doubt that exciting times are ahead.