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Prior to the influx of tailors over a century ago, Savile Row was filthy with surgeons. When tailors started to move in, they accommodated their local clientele by making jackets with functional sleeve buttons that could be unfastened and rolled back, enabling a surgeon to work on a patient without removing his jacket. Hence, surgeon’s cuffs.
Obviously, it would take much less time to simply remove a modern day jacket, making surgeon’s cuffs as ornamental as fake ones. But they’re such a fun detail. Most jackets today come with four sleeve buttons, some come with three (or less if a designer is playing a trendy card). On my own jackets, I often leave the last one unfastened as a subtle flourish or to make room for a bulky cuff link.
Nowadays, bespoke or custom tailors offer surgeon’s cuffs as a standard option. Most off-the-peg offerings do not, usually sewing the buttons onto fake “stitched” button holes that don’t open. (Though Suitsupply‘s off-the-peg suits have functional sleeve buttons.) J.Crew does even less on their jacket sleeves, forgoing the fake stitched button holes, which enables a tailor to detach the buttons and alter sleeve length easily. Once the sleeve is altered, a good tailor can even make the buttons functional if one wishes.
As I said, surgeon’s cuffs are technically just as cosmetic as non-functional buttons. They’re almost purely decorative, like ties, pocket squares, lapel pins or even tie bars. But they provide a subtle accent and detail to a jacket that I absolutely love.