Purpose: Plastic and reconstructive surgery in Australia and New Zealand (ANZ) is inextricably linked to global conflict. This historical review explores the transformative impact of World War I (WWI) and World War II (WWII) on the specialty’s development. It traces the lineage of modern practice from the battlefields of Europe to the establishment of dedicated ANZ units, highlighting the contributions of pioneering surgeons. Methodology: A review of historical archives, surgical literature, and biographical records was conducted. The analysis focused on innovations by key figures such as Sir Harold Gillies and Sir Archibald McIndoe, and the subsequent return of ANZ surgeons—including Henry Pickerill, William Manchester, and Benjamin Rank—who institutionalized the specialty within civilian health systems post-conflict. Results: WWI’s unprecedented facial injuries led New Zealander Sir Harold Gillies to pioneer the tubed pedicle flap and multidisciplinary care. These principles were refined during WWII by Sir Archibald McIndoe, whose holistic treatment of burned airmen (the "Guinea Pig Club") introduced saline baths and emphasized psychosocial rehabilitation. Returning surgeons transposed these innovations to the civilian sector: Pickerill and Manchester established units in New Zealand focusing on cleft and maxillofacial repair, while Benjamin Rank founded the Victorian Plastic Surgery Unit in Australia. This knowledge transfer catalyzed the recognition of plastic surgery as a distinct specialty, independent of general surgery. Conclusion: Modern ANZ plastic surgery is a direct descendant of wartime innovation. The specialty’s "founding fathers" converted battlefield necessity into a disciplined restorative art. Today’s practice - encompassing microsurgery, burns, and craniofacial surgery - remains rooted in the principles of form, function, and patient-centered care forged during the 20th century’s defining conflicts.