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Rhinoplasty (Greek; Rhinos, “Nose” + Plastikos, “to shape”) is a type of plastic surgery that is used to improve the function (reconstructive surgery) or appearance (cosmetic surgery) of a person’s nose. Rhinoplasty is also commonly called a “nose job.”

Rhinoplasty was first developed by Sushruta, an important physician (often regarded as the “father of surgery”) who lived in ancient India circa 500 BC, which he first described in his text Susrutha Samhita. He and his later students and disciples used rhinoplasty to reconstruct noses that were amputated as a punishment for crimes. The techniques of forehead flap rhinoplasty he developed is practiced almost unchanged to this day.

Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to correct birth defects or breathing problems.

The first intranasal rhinoplasty was performed by John Orlando Roe in 1887 but was later pioneered by Jacques Joseph (b. Jakob Lewin Joseph) in 1898 to help those who felt that the shape or size of their nose caused them embarrassment and social discomfort. His first rhinoplasty patient was a young man whose large nose caused him such embarrassment that he felt unable to appear in public. He approached Joseph because he had heard of a previous successful otoplasty, or “ear job,” which the surgeon had performed.

Rhinoplasty can be performed under a general anesthetic or with local anesthetic, depending on patient or doctor preference. Incisions are made inside the nostrils. Sometimes, tiny, inconspicuous incisions are also made on the columella, the bit of skin that separates the nostrils. The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the cartilage and bone causing the perceived deformity.

In some cases, the surgeon may shape a small piece of the patient’s own cartilage or bone to add to, strengthen, or increase the structure of the nose. Sometimes this is done for cosmetic reasons (to improve the shape of the nasal tip, for example) or it may be done to improve breathing and function of the nose.

In rarer cases, a synthetic implant may be used to reconstruct the nose if the normal structure of bone and cartilage is badly damaged or weakened. Alloplastic synthetic materials are often associated with long-term complications such as migration and extrusion. Alternatively, cartilage from the septum, ear or rib may be used.

To improve nasal function, a septoplasty may be performed, with or without cosmetic changes. The cartilage that is removed may be used as a graft to improve the appearance and structure of the nose.

In the entertainment industry

The Los Angeles Examiner of May 5, 1930, stated that:

“Having one’s nose shaped to fit the talkies is the most popular thing in Hollywood now. Hollywood plastic surgeons agree that more than 2000 facial beautification operations have been performed among film players within the past few years.”

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