A Brief History of Rhinoplasty

A rhinoplasty, more commonly known as a nose job, is one of the better known plastic surgery procedures and has been performed since 1794.  Rhinoplasty was first developed by Sushruta, who many refer to as the father of plastic surgery.  He and his later students used rhinoplasty to reconstruct noses that were amputated as a punishment for crimes. The techniques of forehead flap rhinoplasty he developed are practiced almost unchanged to this day and are used to reconstruct noses after skin cancer surgery or after major trauma. . This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman’s Magazine (October, 1794). As the techniques of reconstruction evolved the concept of improving the appearance of the nose for cosmetic reasons developed.

Today, the term rhinoplasty generally refers to cosmetic improvement of the nose. While originally a reduction operation, i.e. making the nose smaller, the art of rhinoplasty has evolved where some parts of the nose may be reduced while other parts may be enhanced using the patient’s own cartilage or bone as a graft to add support and change the shape of the nose. Synthetic implants should generally be avoided as the complications can be very difficult to correct.

A skilled rhinoplasty surgeon must have a keen aesthetic eye, an in-depth understanding of nasal anatomy and function, and the technical skills to create a pleasing natural appearing nose that functions properly.

Although rhinoplasty is usually considered to be safe and successful, several complications can arise. Post operative bleeding is uncommon and often resolves without needing treatment. Infection is rare and can occasionally progress to an abscess that requires surgical drainage under general anesthetic. Adhesions, which are scars that form to bridge across the nasal cavity from the septum to the turbinates, are also rare but cause nasal obstruction to breathing and usually need to be cut away. A hole can be inadvertently made at the time of surgery in the septum, called a septal perforation. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.