Rhinoplasty, also called nose surgery and nose reshaping, has been at or near the top of the list of high-demand plastic surgery procedures for a very long time. At least 3000 years, to be more precise. With that kind of history and steady patient interest, it’s no wonder that rhinoplasty continues to evolve with the development of new technology and changing patient desires.
The first recorded rhinoplasty surgeries were performed in India as far back as 1000 B.C. It was a procedure that rebuilt the nose using skin from elsewhere on the face or another part of the body. Demand for the surgery arose because cutting off the nose was a traditional form of punishment in Indian society, according to Jacques Joseph, widely considered as the father of modern facial plastic surgery, in a textbook he authored nearly 100 years ago that is still in use today.
During the late 1800’s and early 1900’s, nose surgery was starting to become more refined and increasingly available in pockets of both Europe and the U.S. John Orlando Roe, a New York surgeon, performed the first known intranasal, or surgery from inside the nose, in 1887. (Today this technique is routine.) Several years later, Jacques Joseph furthered his skills and reputation by restoring the faces of German soldiers in World War I at a Berlin hospital.
Steady demand for rhinoplasty is ongoing, as patients seek to repair injuries and reshape noses out of proportion to the rest of their facial features. The American Society for Aesthetic Plastic Surgery (ASAPS) reports that more than 150,000 U.S. patients elected the procedure in 2008. Perennially in the top five, rhinoplasty is topped only by breast augmentation, liposuction and eyelid surgery in terms of popularity.
Nose surgery continues to evolve to meet patient demands. The ASAPS noted earlier this year that although ethnic minorities now account for about 20% of all cosmetic procedures, many have been hesitant to seek rhinoplasty for fear of losing their ethnic identity. In the annual society meeting in May, several plastic surgeons came together to present a paper titled, “Ethnic Rhinoplasty – Creating Shape While Preserving Ethnicity.” One of the authors, Dr. Julius Few, was quoted as saying, “many of these patients simply want to have features more commonly found in other family members – not features of specific celebrities or other racial/ethnic groups.” Dr. Few believes that rhinoplasty for ethnic minorities needs to be about the overall balance of facial features, just as it is for Caucasian patients, not about erasing heritage.
For some who want to improve the look of their nose without surgery, the recent advent of facial fillers like Radiesse® has been great news. Although injections of dermal fillers can’t achieve the dramatic, lasting results of surgery, they can deliver surprisingly effective changes with no downtime and a price tag of a few hundred dollars rather than a few thousand dollars.
Often promoting this option as “non-surgical rhinoplasty,” plastic surgeons tend to recommend this route for:
- building up the nasal bridge, or dorsum
- straightening a “nasal hump”
- reducing wide nostril flare
- resolving minor imperfections from previous surgeries
It’s completely understandable that people who are very unhappy with the shape and/or size of their nose, whether because of injury or Mother Nature’s whims, dream about correcting the problem. After all, while there are options for disguising very large breasts, saddle bags or love handles, there’s really no way to hide your nose. The good news is that plastic surgeons have more options than ever in their toolkits.