The Origins of Rhinoplasty: The Evolution of Reconstructive Surgery into the Modern Aesthetic

A rhinoplasty, commonly known as a nose surgery, is one of the oldest surgical procedures recorded in history. It's mostly known for cosmetic changes in appearance, but is also used to improve function or correct problems. The earliest known rhinoplasties date back to 3000–2500 BCE, as ancient Egyptian medical texts describe the repair of noses lost to punishment (which permantently marked individuals as criminals) or injuries through battles, were repaired using splints, wood, or linen to maintain structure during healing. 

A significant impact of the rhinoplasty occurred back around the 6th century BCE. Dr. Sushruta created a technique, called flap, that required using the skin from the forehead to reconstruct noses lost to punishment. This revolutionized how rhinoplasty procedures were done as it depended on actual human skin rather than foreign materials, appearing more natural on the face.  

During the Renaissance era in Europe, Italian surgeons adapted and revolutionized the flap technique created by Dr. Sushruta. Rather than using the skin on the forehead, they used the skin on the arms and called it the “Italian method”. In 1597, Gaspare Tagliacozzi published his work De Curtorum Chirurgia per Insitionem, detailing the “Italian method” using arm skin flaps to reconstruct noses. He emphasized restoring not only form but also the spirit. 

During the 19th century, Dr. Karl Ferdinand von Graefe enhanced Tagliacozzi’s method by introducing the free-graft method, which involved using detached skin from the arm. Dr. Christian Heinrich Bünger performed the first skin graft procedure using Dr. von Graefe’s method and introduced rhinoplasty to Europe. French surgeon Philippe-Frédéric Blandin further advanced grafting techniques in the early 19th century, using “autoplasty” for grafts using the patient's own tissue.

All of these enhancements to rhinoplasty have paved the way for the modern techniques used today, where rhinoplasty is no longer just for reconstruction, but also an aesthetic art where people can create changes in their appearance to their likings. Today, rhinoplasty solves not only appearance but also functional issues such as breathing problems.

Written by Sofia Bonilla at Incisionary

APA References

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