Spotlight on Rhinoplasty: A history of the nose job
Derived from the Greek words ‘rhinos’, for nose, and ‘plastos’ which means ‘shaped’ or ‘molded’, Rhinoplasty is thought to be the world’s oldest cosmetic surgery procedure.
Nowadays, a Rhinoplasty procedure encompasses many techniques to alter all aspects of the nose, both for aesthetic and functional purposes. A bump or hook on the bridge of the nose can be removed, the tip or nostrils made smaller, cartilage straightened, the overall nose made smaller or the angle of the nose to the lip improved. Poor breathing can also be addressed. Nose reshaping surgery has constantly evolved from its earliest origins and today approximately 4,000 Rhinoplasty procedures are performed per year in the UK by BAAPS surgeons.
Rhinoplasty in Ancient Egypt
A common punishment in Ancient Egypt was to have the nose removed, which gave rise to the development of techniques to rebuild the nose that was recorded on papyrus dating from 3,000 BC. The Rhinoplasty procedure was detailed in the Ebers Papyrus, Egypt’s oldest-known guide to medicine.
Rhinoplasty in India
Crime and punishment was also the driving force behind the development of Rhinoplasty in India. Living some time between 1200 and 600 BC, Sushruta carried out reconstruction of noses of criminals, as well as men and women whose noses had been disfigured through trauma (dacoits – armed robbers – would often cut off the noses of their victims) or illness, with the use of skin grafts.
Most importantly, he is credited as inventing the Forehead Flap Rhinoplasty and modifications of his techniques are still very much part of the modern plastic surgical repertoire.
The Spread of Rhinoplasty
Many Indian medical texts, including the ‘Sushruta Samhita’, were translated by Arabian physicians and from there information on a wide range of surgical procedures, including Rhinoplasty, spread, arriving in Southern Europe in the 1400s, the earliest European Rhinoplasty being performed by the Sicilian based surgeon, Branca, in 1442.
Modern-day Rhinoplasty
The famous Italian surgeon, Gaspare Tagliacozzi, was an innovator in facial plastic surgery including Rhinoplasty. He performed many operations on soldiers disfigured in battle and detailed his discoveries and techniques in his guide, ‘The Surgery of Defects by Implantations’. His definitive biography, ‘The Life and Times of Gaspare Tagliacozzi, surgeon of Bologna, 1545 – 1599’ by Martha Gnudi and Jerome Webster (a distinguished American Plastic Surgeon), published in New York by Herbert Reichner in 1950 (limited edition) is highly recommended.
For the next couple of centuries, Rhinoplasty was mainly performed to rebuild noses, destroyed through battle injuries or other trauma, Forehead Rhinoplasty being popularised in Europe (where it became known as ‘Carpue’s operation’) by Joseph Carpue, a surgeon at St George’s Hospital in London through his publication ‘An Account of Two Successful Operations for Restoring a Lost Nose from the Integument of the Forehead’.
In 1887, an American ENT surgeon, John Orlando Roe, performed the first Cosmetic Rhinoplasty. He operated on a man in his 20s who suffered great embarrassment and distress due to his large nose. The success of the nose reshaping procedure greatly increased his quality of life, the hallmark of all successful cosmetic surgery .
War played a major role in the development of Rhinoplasty techniques and the World Wars of the twentieth century greatly advanced what surgeons were able to achieve, both to improve form and function of the nose. Anaesthetic became much more safer, allowing more patients to undergo an elective procedure. The German surgeon, Jacques Joseph, (1865-1943), is widely acknowledged as the Father of modern Aesthetic Rhinoplasty and the Joseph Elevator remains an instrument commonly used in its execution
After World War II, many Hollywood stars went under the knife to improve their appearance. Since then, Cosmetic Rhinoplasty or nasal reshaping surgery has become a common procedure for both men and women. For more information on Rhinoplasty or any Cosmetic Surgery procedure, book a consultation at my Leamington Plastic Surgery Clinic by calling 01926 436341.