The name rhinoplasty is taken from the Greek rhis and plassein and is regarded as one of the most artistic procedures in facial plastic surgery. Although changing the nose may be desirable for functional reasons, nasal surgery is popular for cosmetic improvement. In fact, cosmetic procedures such as nose jobs have been practiced for millennia.
An Indian doctor that lived around 600 BCE, known as Sushruta is considered the pre-eminent pioneer of reconstructive surgery. Sushruta wrote extensively about plastic surgery techniques in his famous medical text; the Sushruta Samhita. Although dating to antiquity, the text goes into amazing detail on plastic surgery techniques and tools that are in use today.
Reconstructive procedures were common place in ancient India because nose amputation became a widespread punishment for criminal offenses. The need to repair damage like this and other punitive amputations fostered an environment where surgical techniques could be innovated on an endless supply of patients willing to pay for their reconstruction.
Although plastic surgery, and particularly nasal reconstruction, had been innovated on the subcontinent there were also attempts at reconstructive process in ancient Rome. Aulus Cornelius Celsus published “De Medicina” (On Medicine) around 30CE. In the Fifth Century CE, physician to the Byzantine royal family Oribasius published his compendium “Synagogue Medicae” detailing procedures such as debridement to remove tissue necrosis. During the Indian Colonial period, British surgeons who studied the ancient Ayurvedic procedures for nasal reconstruction brought them to the Western Hemisphere by publishing an article in Gentlemen's Magazine in 1794. Famous British surgeon, Joseph Constantine Carpue, studied in India for 20 years learning the craft of nasal reconstruction.
In the late 19th Century, a young German surgeon, named Jacques Joseph, performed the first successful modern rhinoplasty in Berlin. Both Joseph and Parisian surgeon Bourget performed and expanded aesthetic rhinoplasty. Aside from surgical technique, many of the instruments used today for nasal procedures were developed by Joseph. He also introduced what today is known as the endonasal rhinoplasty, a technique using only internal incisions and avoiding external cust and subsequent scarring.
Although the technique of the “open” rhinoplasty was popular in Europe, it took until the late 1970s and 80s to be explored in the United States. In 1990, facial plastic surgeons, Johnson and Toriumi, published “Open Structure Rhinoplasty” which introduced open rhinoplasty techniques to American nasal surgeons. As skill and technique continue to progress, the options in nasal reconstruction for functional and cosmetic purpose enjoy widespread popularity.
