This book traces the career of pioneering South African plastic and reconstructive surgeon, Jack Penn, from its beginnings during the Second World War. It explores the establishment of Penn’s private practice, and his work in diverse countries, including Gabon, Japan and Israel, as he sought to rectify the injury caused by conflict. It also addresses his role on the President’s Council, established by Prime Minister P.W. Botha to introduce reform to the system of apartheid. Penn’s career is contextualised by modernisation which was a significant feature of twentieth-century South Africa. It was linked with race from the inception of the state in 1910 with racial segregation and paternalism. Penn’s work during the Second World War was part of a “modernist” bent by the state under Jan Smuts to take the lead in promoting science and technological development – which continued during apartheid. Modernisation was also fluid with state priority shifting between the two poles of development and security as apartheid policies were met with hostility both within the state and beyond its borders. Within the context of decolonisation, increasing black urbanisation required a balancing act on the part of the state to uphold the ideology of racial distinction while simultaneously addressing economic challenges – and this was reflected in the reform initiatives under Botha. Plastic and reconstructive surgery as evident in the work of Jack Penn is intertwined with this narrative of apartheid, modernisation and reform. It demonstrated Western prowess, with medicine and development a perceived bulwark against Communism. It also served as a means for the modernising apartheid state to initiate, maintain or enhance alliances with other states in the facing of mounting isolation and international condemnation. The career of Jack Penn, then, is a lens through which the contradictions, complexities and anxieties of twentieth-century South Africa are exposed.