page_title: Rhinoplasty
section_title: History
hierarchical_section_title: Rhinoplasty / History
caption_attribution_description: English: The Edwin Smith papyrus, the world's oldest surviving surgical document. Written in hieratic script in ancient Egypt around 1600 B.C., the text describes anatomical observations and the examination, diagnosis, treatment, and prognosis of 48 types of medical problems in exquisite detail. Among the treatments described are closing wounds with sutures, preventing and curing infection with honey and moldy bread, stopping bleeding with raw meat, and immobilization of head and spinal cord injuries. Translated in 1930, the document reveals the sophistication and practicality of ancient Egyptian medicine. Plate 6 and 7 of the papyrus, pictured here, discuss facial trauma. Français&#160;: Le papyrus Edwin Smith est le plus ancien document original traitant de chirurgie. Écrit en caractères hiératiques pendant le Nouvel Empire de l’Égypte antique, vers le XVIIe siècle avant notre ère, ce traité décrit avec force détails les observations anatomiques et cliniques, les traumatismes et les traitements appliqués pour 48 affections médicales relevées sur un grand nombre de cas, ainsi que les pronostics associés à ces traitements. Il mentionne différents actes chirurgicaux, la fermeture avec les premières descriptions connues des sutures des plaies thoraciques. On y trouve aussi des traitements préventifs ou curatifs, des pharmacopées antibiotiques proposés pour lutter contre les infections avec le miel et le pain moisi, l’arrêt des hémorragies avec de la viande crue, et l’immobilisation des blessures à la tête et à la moëlle épinière. Traduit dans les années 30, le document révèle la sophistication et la praticité de la médecine de l’ancienne Égypte. Les planches 6 et 7 présentées ici discutent des traumatismes faciaux.
context_page_description: Rhinoplasty, commonly known as a nose job, is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery also treats birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition.
context_section_description: Treatments for the plastic repair of a broken nose are first mentioned in the Edwin Smith Papyrus, a transcription of text dated to the Old Kingdom from 3000 to 2500 BCE. 
  The Ebers Papyrus (c. 1550 BC), an Ancient Egyptian medical papyrus, describes rhinoplasty as the plastic surgical operation for reconstructing a nose destroyed by rhinectomy, such a mutilation was inflicted as a criminal, religious, political, and military punishment in that time and culture.
  Rhinoplasty techniques are described in the ancient Indian text Sushruta samhita by Sushruta, where a nose is reconstructed by using a flap of skin from the cheek.
  During the Roman Empire (27 BC – 476 AD) the encyclopaedist Aulus Cornelius Celsus (c. 25 BC – 50 AD) published the 8-tome De Medicina (On Medicine, c. 14 AD), which described plastic surgery techniques and procedures for the correction and the reconstruction of the nose and other body parts.
  At the Byzantine Roman court of the Emperor Julian the Apostate (331–363 AD), the royal physician Oribasius (c. 320–400 AD) published the 70-volume Synagogue Medicae (Medical Compilations, 4th century AD), which described facial-defect reconstructions that featured loose sutures that permitted a surgical wound to heal without distorting the facial flesh; how to clean the bone exposed in a wound; debridement, how to remove damaged tissue to forestall infection and so accelerate healing of the wound; and how to use autologous skin flaps to repair damaged cheeks, eyebrows, lips, and nose, to restore the patient's normal visage.
  In Italy, Gasparo Tagliacozzi (1546–1599), professor of surgery and anatomy at the University of Bologna, published Curtorum Chirurgia Per Insitionem (The Surgery of Defects by Implantations, 1597), a technico–procedural manual for the surgical repair and reconstruction of facial wounds in soldiers. The illustrations featured a re-attachment rhinoplasty using a biceps muscle pedicle flap; the graft attached at 3-weeks post-procedure; which, at 2-weeks post-attachment, the surgeon then shaped into a nose.
  In Great Britain, Joseph Constantine Carpue (1764–1846) published the descriptions of two rhinoplasties: the reconstruction of a battle-wounded nose, and the repair of an arsenic-damaged nose. (cf. Carpue's operation).
  In Germany, rhinoplastic technique was refined by surgeons such as the Berlin University professor of surgery Karl Ferdinand von Gräfe (1787–1840), who published Rhinoplastik (Rebuilding the Nose, 1818) wherein he described 55 historical plastic surgery procedures, and his technically innovative free-graft nasal reconstruction (with a tissue-flap harvested from the patient's arm), and surgical approaches to eyelid, cleft lip, and cleft palate corrections. Dr. von Gräfe's protégé, the medical and surgical polymath Johann Friedrich Dieffenbach (1794–1847), who was among the first surgeons to anaesthetize the patient before performing the nose surgery, published Die Operative Chirurgie (Operative Surgery, 1845), which became a foundational medical and plastic surgical text (see strabismus, torticollis). Moreover, the Prussian Jacques Joseph (1865–1934) published Nasenplastik und sonstige Gesichtsplastik (Rhinoplasty and other Facial Plastic Surgeries, 1928), which described refined surgical techniques for performing nose-reduction rhinoplasty via internal incisions.
  In the United States, in 1887, the otolaryngologist John Orlando Roe (1848–1915) performed the first modern endonasal rhinoplasty (closed rhinoplasty) and about his management of saddle nose deformities.
  In the early 20th century, Freer, in 1902, and Killian, in 1904, pioneered the submucous resection septoplasty (SMR) procedure for correcting a deviated septum; they raised mucoperichondrial tissue flaps, and resected the cartilaginous and bony septum (including the vomer bone and the perpendicular plate of the ethmoid bone), maintaining septal support with a 1.0-cm margin at the dorsum and a 1.0-cm margin at the caudad, for which innovations the technique became the foundational, standard septoplastic procedure. In 192
caption: Plates vi & vii of the Edwin Smith Papyrus at the Rare Book Room, New York Academy of Medicine[1]
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