Medical Trailblazer

The country’s first plastic surgeon hailed from Prince Edward County.

In the mid-19th century, patients seeking the best medical care would travel—even from abroad—to see a Virginia country doctor. And for good reason. John Peter Mettauer of Prince Edward County was widely regarded as one of the finest surgeons alive.

The son of a military surgeon who came to Virginia with the Marquis de Lafayette from France, Mettauer graduated from Hampden-Sydney College in 1806 and left for Philadelphia to earn his medical degree from the University of Pennsylvania under Philip Physick, the Father of American Surgery. But he returned to his beloved Virginia to build his own practice among the Southern pines.

A bit eccentric and known for wearing a tall stovepipe hat, Mettauer was also brilliant, performing nearly every operation then known, often improving upon standard techniques.

He became recognized as the country’s first plastic surgeon after he successfully repaired a cleft palate in 1827. A decade later, Mettauer pioneered a vaginal fistula repair that would go on to become a standard therapy in women’s healthcare. An avid writer, Mettauer filled the nation’s medical journals with new treatment methods, making invaluable contributions to the science of medicine.

In 1837, Mettauer responded to the lack of medical schools in the U.S. (there were 12 at the time; just three in the South) by establishing his own institute. His 30 students formed a corps of nurses and assistants, increasing his capacity to treat patients while producing future practitioners.

The trainees even helped Mettauer, an ingenious mechanic, construct surgical instruments out of silver and iron—some of which remain on display at Hampden-Sydney. In 1848, his institute became the Medical Department of Randolph-Macon College, then located in the town of Boydton. Two of his own sons joined him on the faculty.

During his career, Mettauer performed more than 800 cataract operations, and at age 88, in the last week of his life, he performed three final operations: “His eyes were yet keen enough and his hands steady enough for him to make a successful operation,” said George Ben Johnston, president of the American Surgical Association, in a 1905 tribute to the good doctor.

In a posthumous tribute, the American Journal of Medical Sciences credited him “with more improvements in operations and inventions of instruments to date than any other man.”

Through it all, Mettauer wore his towering top hat, even at meals—and once, famously, and to one judge’s chagrin, while testifying in court. His last instruction, it was said, was to bury him with his hat on.


This article originally appeared in the February 2022 issue.

Dean King
Dean King is the author of 10 award-winning works of nonfiction who has trekked, explored, and traipsed the globe in search of crafting a story. A frequent contributor to The New York Times, Garden & Gun, Outside, and more, he lives in Richmond.
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