Thinking about getting that long dreamed of nose job in 2017? Nose surgery may seem very daunting but it’s one of the oldest forms of cosmetic surgery, dating back thousands of years.
There’s been a lot in the press recently about new non-surgical ways to change one’s nose shape. These include an uncomfortable plastic insert to alter the shape of the nostrils and nose tip, and liquid rhinoplasty, the so-called ‘lunch break nose job’, carried out using injectable fillers.
However, reticence about actually going under the knife means people using these tactics must put up with either discomfort or inferior results. For anyone truly unhappy with their nose, surgery will always be the best option.
There is a lot of fear and misunderstanding around rhinoplasty, but for experienced surgeons it’s a straightforward surgery with an extremely small risk of serious complication – they’ve been doing it for years; 2,600 years to be exact.
Rhinoplasty’s roots date back to 600 BC
Nose surgery is an ancient art first referenced in The Compendium of Suśruta, a Sanskrit text on medicine and surgery, written in 6th century India.
The text was written by Sushruta, known today as the ‘Father of Plastic Surgery’, and includes historically unique chapters describing surgical training, instruments and procedures.
However, Sushruta’s innovations in nose surgery were motivated by necessity, as opposed to simply wanting to help patients change their appearance for cosmetic reasons.
Removal of noses (and ears) was a common punishment in wartime or for those who committed adultery or treason. Sushruta therefore developed a method to reconstruct damaged noses. His method involved removing flaps of skin from the forehead or cheek of the patient and using it to reconstruct the nose:
“The portion of the nose to be covered should be first measured with a leaf. Then, a piece of skin of the required size should be dissected from the living skin of the cheek, and turned back to cover the nose, keeping a small pedicle attached to the cheek.
“The part of the nose to which the skin is to be attached should be made raw, by cutting the nasal stump with a knife. The physician then should place the skin on the nose and stitch the two parts swiftly, keeping the skin properly elevated, by inserting two tubes of eranda (the castor-oil plant) in the position of the nostrils, so that the new nose has proper shape. The skin thus properly adjusted, it should then be sprinkled with a powder of liquorice, red sandal-wood, and barberry plant.”
|Artificial noses were also used during the |
16th and 17th centuries. Credit: Science
Museum London - CC BY-SA 2.0
Sushruta’s method was known to the ancient Romans, with the term ‘rhinoplasty’ derived from the Greek words 'Rhinos' and 'Plassein', meaning nose and shape.
However, the technique wasn’t embraced by Western medics until many years later, during the syphilis epidemic of the late 16th century. Syphilis can destroy the soft tissue of the nose resulting in a gaping hole in the middle of the patient’s face. This could lead to severe social stigmatisation so suffers required treatment not just for the physical pain.
From reconstruction to refinement
Advancements in nose surgery continued throughout the 17th and 18th centuries, with the first rhinoplasties to decrease or increase the size of a patient’s nose seen in the 19th century.
Jacques Joseph of Berlin developed techniques for performing nose-reduction rhinoplasty via internal incisions. Fellow German Johann Friedrich Dieffenbach was among the first surgeons to anaesthetise the patient before performing nose surgery.
In the United States, in 1887, John Orlando Roe wrote about using closed rhinoplasty to correct saddle nose deformities. And by 1902, a septoplasty procedure for correcting a deviated septum had been developed.
In the 100 years that followed nose surgery grew in popularity, with cosmetic surgery embraced by the Hollywood stars of the 40s and 50s – Elizabeth Taylor, Dean Martin and Marilyn Monroe are all said to have had rhinoplasty surgery.
Rhinoplasty in the 1950s:
Back then rhinoplasty was so expensive it was necessary to be a movie star or very wealthy to be able to afford it. Now, the techniques have been refined and refined, making it a simpler and safer surgery and bringing the cost down significantly.