Rhinoplasties (nose jobs) are one of the most popular facial cosmetic surgical procedures across all age groups. Whether done strictly for aesthetic reasons or to correct for a deformity or injury, thousands of patients are getting their noses shortened, lengthened, narrowed, or widened.

While rhinoplasty surgical techniques are very advanced these days, it was certainly not the case for many years. In fact, the history of rhinoplasties stretches all the way back to ancient Egyptian medical texts. As was the case with many cosmetic surgical procedures that are now performed out for aesthetic purposes, the roots of the rhinoplasty can be found in attempts to reconstruct the nose due to traumatic injury to the face.

Ancient Times

The first mentions of rhinoplasty techniques can be found in a translation of an ancient Egyptian medical text dating back to sometime between 3000 BC and 2500 BC. Several thousand years later (500 BC), the Ayurvedic Indian physician Sushruta described a technique to rebuild the nose that involved using a flap of skin from the forehead to rebuild the nose. This is particularly notable, as the technique is similar to ones in use today. There are also descriptions of rhinoplastic procedures in medical texts from both ancient Rome and the Byzantine Empire.

Middle Ages and Renaissance

While much of the ancient medical texts were lost to Western Europe, they did survive and were elaborated on by physicians in the Middle East. By the 15th century, Sushruta's techniques were rediscovered and beginning to make their way to the Arabic world. In the 16th century, the Italian physician Gasparo Tagliacozzi described a technique to rebuild the nose using part of the bicep muscle, which was actually left attached to the arm. After several weeks, the graft was cut entirely loose from the arm and used to reshape the nose.

18th and 19th Centuries

As a result of British colonization of India during the 18th century, Sushruta's rhinoplasty techniques were rediscovered by physicians working for the East India Company. By the late 18th century, accounts of the forehead flap technique described thousands of years earlier were found within British publications.

The 19th century saw publication of a number of refinements on rhinoplasty techniques. Among these were texts describing how to perform a nose reduction using only internal incisions, as well as a graft technique from the arm that improved upon Tagliacozzi's work by not leaving the graft attached to the arm. In 1887, the American otolaryngologist John Orlando Roe performed the first modern closed rhinoplasty, in which all incisions and sutures were internal.

20th Century

Much of the 20th-century work on rhinoplasty focused on open rhinoplasties, in which external incisions and grafts are used. By this time, the best practice was to use an open rhinoplasty for the first procedure and save closed rhinoplasties for surgeries needed to correct any failures from the first surgical attempt.

Nowadays, a rhinoplasty procedure can be done on an outpatient basis, with complete healing generally within four to six weeks. This is certainly a far cry from the ancient beginnings for the procedure.