Understanding The History Of Rhinoplasty

Commonly known as a nose job, this is a surgical procedure that many people have to change the shape and size of their nose. Some people could have it as cosmetic surgery, but other people have it as a medical procedure to improve the way they breathe through their nose.

People either have open or closed nose jobs depending on the extent of correction they need. If you are interested in knowing all about nose job surgery, a good place to start would be knowing about its history.

When Did Nose Jobs Start?

Nose jobs go as far as the beginning of 3,000 BC in Egypt. Around that time, rhinectomy was a popular punishment for many criminals found guilty of theft or any political or religious crimes. Rhinectomy involved having the criminals’ noses mutilated.

Egyptian physicians developed ways to help reconstruct those noses, and they wrote their methods in hieroglyphics.

At the beginning of 500 BC, India also started practicing the amputation of criminal noses. Sushruta Samhita, an Indian physician, was the first person who practiced nose reconstruction surgery with methods more advanced than those of the Egyptians.

He performed a lot of his first nose jobs on people who had lost their noses due to criminal punishments. A lot of people continued to lose their noses or have them destroyed in the war due to diseases like syphilis and due to poisonous gases.

Although the surgery did not get the noses back to their original shape and form, they helped disguise and minimize the symptoms of nose deconstruction and loss.

Evolution Of Nose Job Techniques

The forehead flap technique was the method that Sushutra first used when he started doing nose jobs on the prisoners who had lost their noses. This method involved using the person’s skin flap in reconstructing their nose.

This method stuck around until the 16th century; the west suffered a great hit of syphilis that saw patients suffer disfigured and rotting noses.

At that time, the forehead flap technique that Sushutra introduced became somehow inadequate in fixing the problem. Therefore, Gasparo Tagliacozzi, an Italian surgeon, came up with a new method he called the Italian Method.

That method involved him using skin from the patient’s upper arm to conduct the nose reconstruction. Also, the patients had to have their upper arms strapped to their noses for around 2-3 weeks to ensure that the nose healed properly.

To maintain that position, the patients had their forearms strapped to their heads. That allowed the skin from the bicep or upper arm to attach properly to the nose.

The people who mainly benefited from this method of nose reconstruction surgery were the soldiers who had their noses deformed or badly injured in battle.

In 1597, Gasparo Tagliacozzi wrote The Surgery of Defects by Implantations, which described his nose reconstruction procedures in detail.

One of the major downsides to this method of nose reconstruction is that during the cold seasons, the new noses sometimes turned purple and eventually fell off, which led the Italian method to go out of use.

In the 1800s, nose jobs entered another developmental era in the western world. In 1815, Joseph Constantine Carpue wrote a book that detailed surgical procedures for restoring noses of patients that were destroyed by arsenic and in war.

During the same year, Dr. Karl Ferdinand von Grafe wrote a book on nasal reconstruction techniques in Germany. Many people consider Dr. Karl, a plastic surgeon innovator.

He used works that previous plastic surgeons like Gasparo Tagliacozzi had used to come up with more advanced and specialized techniques.

The book he wrote contains over 50 ancient plastic surgery techniques used all around the world, including his own, which is known as a free-graft nasal reconstruction.

People underwent nose reconstruction surgeries at those times only to give an appearance of replacing or to replace the nose they lost due to war or disease. However, during the late 19th century, people started undergoing nose jobs purely for cosmetic purposes.

That means that people started having nose reconstruction surgeries to reshape or resize their noses that did not have any previous problems.

In 1887, John Orlando Roe, who was an American otolaryngologist, documented what people consider the initial modern closed rhinoplasty. He did that on a patient who had emotional distress and embarrassment because of an unusually big nose, also called ‘pug nose.’

John Roe performed his surgery using a technique inside the nose, which helped eliminate any externally visible scarring on the patient after recovery.

Around the same time, Jacques Joseph, a German-Jewish surgeon based in Berlin, used a technique similar to that of John Roe to minimize the noses of European Jewry. These surgeries are now listed among the first successful ones in the field of cosmetic plastic surgery.

As World War I and II advanced, more and more nose job techniques emerged, and people started using anesthesia.

Nose Reconstruction Surgery Today

Today nose jobs are among the most sought-after plastic surgeries, with around 213 000 people having it every year. Depending on how much work patients need, surgeons either do an open or closed nose job.

A closed nose job involves the surgeon making the cuts inside the nose. It is suitable for people who have minor issues, and it leaves minimal scars.

An open nose job, on the other hand, involves the surgeon cutting into the nose and sometimes flipping over the skin of the nose. That gives the surgeon more room to conduct more complex procedures and make more changes.

Recently, a lot of technological changes have taken place in the field of nose jobs. One of the most common ones is the piezo nose job, which is also called an ultrasonic nose job.

This method avoids using knives and needles and uses a specialized instrument that uses ultrasonic energy to the bone of the patient. That ensures that there is not a lot of damage to the nose and no scarring, bruising, and swelling.

There is also another minimally invasive nose job procedure, where surgeons use an endoscope. That is a small camera that helps the surgeons to precisely see what they are doing in the patient’s nasal cavity.

If patients do not get the results they wanted from the surgery, they can have a revision nose job, which attempts to fix those problems.

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