Rhinoplasty is the science & art of Aesthetic Nasal Surgery, which remains the most popular cosmetic surgery across all cultures, races, sexes and ages. The history of nasal surgery dates back thousands of years to ancient India where the skillful and compassionate surgeon, Sushruta, devised “cutting edge techniques” using forehead tissue as a “flap” to reconstruct women’s noses that had been cut off as a sign and punishment for adultery! We have fortunately come a long way since those cruel and inhumane times. However some of the techniques used and described by those pioneering ancient reconstructive surgeons are still valid and used today for reconstruction of the nose after trauma, cancer or dog bite injuries. In fact slight modifications of these ancient techniques gave rise to the Para-median Forehead Flap, which is the cornerstone of all significant nasal reconstruction.
The history of Plastic Surgery and its milestones are tightly interwoven with the history and progress in Rhinoplasty. In the 16th century, the Italian surgeon, Gasparo Tagliacozzi, who is considered by most as one of the forefathers of Plastic Surgery, devised a clever “flap” using skin from the arm of a patient to reconstruct the nose by attaching the arm to the nose for a period of time until the arm skin developed its own blood supply from the nose. Although by today’s standards, such a procedure seems gross and primitive, this concept of a “distal flap” is one of the cornerstones of modern reconstructive techniques for very large total nasal defects using methods such as a “Radial Forearm Flap.”
The father of modern Plastic Surgery, John Orlando Roe, who was an Otolaryngologist (ENT) from Rochester, New York, is accurately given credit for performing the first endonasal or “closed” Rhinoplasty and for being the father of aesthetic Rhinoplasty. Later on Jacques Joseph, from Berlin, used this technique to help a young man who was so embarrassed by his overly large nose that he had avoided appearing in public.
During the “taboo period” of plastic surgery when the field was seen as superfluous and was not taken seriously by most surgeons, cosmetic surgery and Rhinoplasty where merely available to the select few of wealth and advantage. However, today more than ever before in history, cosmetic surgery is in the spotlight. It has gained wide acceptance as a valid field of medicine and the rewards of self-improvement, and increased self-confidence, and wellbeing are available for the first time to the general public.
This new “birth” of cosmetic surgery has also resulted in a “flooding” of the market by devices, procedures, and promises that are not always grounded in science and medicine but more so in “marketing” and “hype.” Plastic Surgery is being “sold” today in an alarming rate to the public, in the media and in cosmetic surgeons’ offices.
Fortunately, the field of Rhinoplasty and aesthetic surgery of the nose has by enlarge been shielded from such hype and exposure; (with the few exceptions of the doctors offering “no-downtime-rhinoplasty” by injecting fillers like Radiesse into the nasal bridge in order to create a straighter profile). Overall, Rhinoplasty has evolved properly and stepwise over the last several hundred years into the safe, effective and impressive surgery that it is today when performed by the true “Rhinoplastic surgeon.”
Rhinoplasty is widely considered by all kinds of surgeons to be the most difficult of all surgeries. Hence, the Rhinoplastic Surgeon is considered to be the most meticulous, skilled and exquisite of all plastic surgeons. Aesthetic surgery of the nose is a three dimensional operation of millimeters. The successful Rhinoplasty requires skill, artistry and a complete understand of the nose, its architecture, as well as its functional physiology.
Facial Plastic Surgeons who by training are specialists of the nose are inherently better equipped to deal with these issues. The five to six years of surgical training focusing specifically on the face and nose results in unparalleled skill and expertise.