A History of Rhinoplasty
Albany's Williams Center Presents Nose Surgery, Past and Present
With "nose reshaping" consistently one of the most commonly performed cosmetic surgeries in the modern United States, according to the ASPS, it may be easy to forget that the popular procedure has been around in some form or another for about 2,500 years. When it comes to the history of rhinoplasty, Albany, NY's Williams Center Plastic Surgery Specialists draws on centuries of aesthetic research by scientists and doctors, using cutting-edge techniques and technology to apply that collective knowledge to patients.
The Earliest Nose Surgeries
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General consensus is that the first officially recorded nose surgery in the history of rhinoplasty was in India in the 500s BCE, when written advice recommended using a leaf to measure the necessary tissue, then taking skin from the cheek to be repurposed and reshaped to build a new nose for someone who needed one.
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In fact, many of the earliest surgeries in the history of rhinoplasty were not to change an intact nose for a patient dissatisfied with its size or shape, but to create a nose for men and women who had had lost theirs due to infection or trauma (such as amputation as punishment for a crime). This strategy was apparently necessary enough to warrant instructions in medical texts written in ancient Rome, and it became even more common in the Middle Ages, as the ravages of disease and war prompted many to seek cosmetic correction for the missing facial feature. An absent nose carried with it the stigma of the person having potentially suffered an embarrassing ailment (such as syphilis), so people often sought nasal reconstruction, regardless of how they lost their nose in the first place.
Modern Rhinoplasty: From Function to Form
By the 1700s and into the 1800s, Eastern and Western medicine had intermingled and given rise to new research and techniques. The dominant strategy still involved using flaps of skin to create a new nose in the absence of one, with ideas for donor areas ranging from the cheek to the arm to the forehead. Some flaps were free (meaning they were completely cut from the body), while others were "pedicled" (meaning the donor tissue remained connected to a nourishing blood supply throughout the procedure).
This is also the period when surgery to correct cosmetic problems—such as the scooped-out look of saddle nose deformity—began to take hold. Working on intact noses that just needed a little reshaping also allowed doctors to pioneer the endonasal or "closed" approach, which avoided opening the nose for surgery. Both techniques continued to progress into the 1900s.
Reconstructive surgery resurged in World War I, as disfigured soldiers returned from battle to have parts of their face rebuilt. Some historians believe that the increasingly sophisticated results enjoyed by veterans contributed to the growing acceptance of plastic and cosmetic surgery in Europe and the United States.
The open vs. closed rhinoplasty debate continued through the 1970s, ‘80s, and ‘90s, as both revision and primary nose surgery continued to develop. Today, there are numerous techniques refined to accommodate the various desires of patients, from those who need a nose rebuilt (as with modern victims of war) to those who want their nose to more accurately reflect their preferred appearance by being narrower or having a smaller tip. Modern patients benefit from the abundance of choice, as their surgeon can provide a more personalized approach, with the strategy and techniques customselected to best benefit the individual.