History's First Nose Job

While the first cosmetic nose job didn't happen until the late 1800s

the procedure itself, which was used to help patients who had lost their noses due to war wounds or disease

dates all the way back to around 2,500 years ago. And while other early medical practices like leaching or rubbing animal dung into wounds

often caused more harm than good, the methods used by ancient plastic surgeons were surprisingly effective and modern

albeit incredibly painful. So, today, we're going to take a look at the first nose job, which took place in the 6th century

So, before we really get into it, you need to understand that the historical demand for nose jobs was likely much higher than you probably realize

And there are actually a bunch of good reasons. To start, there has always been innate facial defects that need correction for health reasons

Evidence from regions as widespread as pre-Incan Peru and Roman Scotland shows that people suffered from facial disfigurement

which drove the need for corrective nasal surgery. But an even more common driver of the need for nose jobs

was disfiguration as a result of war or political fallout. Historical evidence shows that some rulers really enjoyed humiliating their enemies

by cutting off their noses. This punishment could create problems for the victims beyond the obvious physical ones

especially in cultures that believed in bodily resurrection, where cutting off someone's nose

could permanently handicap them in the afterlife. For centuries, women accused of wrongdoing

underwent nasal disfigurement as punishment. In the medieval period, for example, a woman might

lose her nose for disobedience or because she was viewed as sexually promiscuous. Examples of such

harsh treatment include a vandal king who at the fall of Rome thought his wife was plotting against

him. So he ordered the disfigurement of her nose and ears. In Jerusalem during the 10th century

women who committed adultery could be punished by cutting off their nose. In fact, many societies

cut off criminals' noses as punishment. In the ancient period, pharaohs used this form of

punishment under the code of Hammurabi and Egyptian law. Similarly, during the medieval period

nasal disfigurement helped identify people found guilty of treason. During the Tudor era in England

anyone who spread lies about the king could have their nose or ears amputated

And a 16th century pope scared off highway robbers threatening Rome by decreeing any man caught robbing people

would have their nose cut off. The punishment stood for so many centuries

that individuals with nose deformities from disease or war injuries may have pursued nose jobs just to avoid misidentification as a criminal The first nose job in history dates all the way back to the 6th century BC

The process was detailed in the Hindu Sanskrit writings of Sushruta, an Indian physician

who today is widely regarded in India as the father of surgery

Among other procedures, Sushruta's book, known as the Sushruta Samhita, recorded the practice of surgically restoring damaged or missing noses

However, unlike the nose jobs of today, which are often performed for cosmetic reasons

Sushruta's patients included people disfigured by disease, wounded in battle, and those who had lost their noses as punishment for adultery or theft

To help these individuals, the doctor used a method that's not too different from what modern plastic surgeons do

He surgically created a flap of skin and rotated it to cover the damaged nose

In fact, his book contains the very first recorded description of a forehead flap rhinoplasty

a procedure that is still used today. Surgeons continued to use Sushruta's method in India for more than 2,000 years

well into the 19th century. For those looking to get an old-school-style nose job

Sushruta's aforementioned text explains how to create the artificial nose. First, the leaf of a creeper, long and broad enough to fully cover the hole

of the severed or clipped part, should be gathered. Now, to be clear, a creeper in this sense

is a small viney plant that grows close to the ground. And its purpose was to give the physician a template

to the size of the wound that would have to be covered by new flesh. But that was just step one

From there, a patch of living flesh, equal in dimensions to the preceding leaf

should be sliced off from down upward from the region of the cheek

and after scarifying it with a knife, swiftly adhere to the severed nose

The text then recommended, a cool-headed physician wrap up the area and let the patient rest

If the procedure succeeded, the skin would graft to the nose. Now, while that might sound easy enough

keep in mind this would have been long before the advent of anesthesia. Moreover, the tools used for early nose jobs

which included gripping devices and knives, made the procedure painful and time-consuming

Those factors likely deterred many from undergoing a nose job procedure and helped explain why the first known nose job for cosmetic purposes

did not occur until the late 1800s. According to Sushruta's ancient manual, after adhering a flap of skin to the patient's nose

the physician should insert two small pipes into the nostrils to facilitate respiration and to prevent the adhered flesh from hanging down The physician then dusted the area with restorative powders and sesame oil Meanwhile the patient while waiting for the procedure to work had to drink clarified butter

and take purgatives. If someone told you they were going to whip your ass and sew your butt to

your face, you'd probably think that person was a bully, threatening you. But historically speaking

you'd be wrong. You see, for centuries, to replace defects on the nose, Indian surgeons

would transplant skin from other parts of the body. Some texts recommend cutting off skin from the buttocks

to attach to the face. And to prepare the thicker butt skin

doctors used an unusual method. They flayed the skin with a whip

so the skin would swell and bruise, then cut off the skin to graft to the face

Some believe the whipping produced a thinner skin layer, which would have a better chance of healing

and grafting to the nose. Did the whole world smell like a bathroom to a person whose nose was made from their rear

Probably not, though it's safe to assume it probably led to a bunch of jokes

Since its entry into the historical record, syphilis has always been bad news

And while the world surely always desired a cure, the first order of business after its

earliest recorded major outbreaks seems to have been figuring out who to blame

Most countries chose to pin it on their neighbors or enemies. For example, records show the residents of Russia called it the Polish disease

while the Polish called it the German disease. England called it the French disease, while the

French called it the Neapolitan disease. The Portuguese called it the Spanish disease. The

Turks called it the Christian disease. And both the Hindus and the Muslims blamed each other

Regardless of who was to blame, the disease caused disfigurement, hair loss, and soft tissue decay

which could destroy the suffering patient's nose. During Europe's major outbreak of syphilis

long before effective treatments emerged. The disease even came to carry a social stigma

By the 16th century, Europeans just generally began to associate facial disfigurements with

disease and infection. This, in turn, drove the desire for nose jobs. And at the time

the most common procedure grafted armskin to the patient's face to create a new nose

Gaspare Tagliacozzi was a professor of anatomy and surgery at the University of Bologna

who, in 1597, wrote a surgery book called Decretorum Chirurgia for Incitumonum, or in English

The Surgery of Defects by Implantations Among other things the book which was written in Latin described how to create a nose for men who suffered facial injuries in battle While it might have been effective

the procedure was not easy on the patient. The surgeon attached skin from the patient's upper

arm to his head, forcing the patient to remain in place for three weeks while the arm skin grafted

to the nose. The book even includes an illustration of a patient wearing a brace that holds the arm

in place at the face, and it looks very uncomfortable. But at least once the three

weeks were up, the patient was good to go, right? No. Actually, the patient then had to wait another

two weeks before the surgeon formed the flap of skin into a nose-like shape, completing the nose

job. Patient patience is a virtue. In the 16th century, Gaspari Tagliacuzzi introduced European

doctors to his procedure for grafting arm skin to the nose. A five-week-long ordeal, many patients

understandably wanted to avoid. Luckily for the noseless of the world, there was an option

The alternative to the painful and awkward surgery was a prosthetic nose made of gold or silver

Amboise Paré, a French surgeon, suggested using prosthetic devices to hide nose deformities or injuries

The device is attached to the face with a string around the head. One famous historical figure who opted for the prosthetic

was astronomer Tycho Brahe, who lost part of his nose in a 1566 duel

and thereafter wore a skin-colored metal nose. In a macabre twist, a grave robber stole the prosthetic nose after Brahe died

For many people throughout history, the nose was a window into a person's character

Metaphorically, of course, don't look in anyone's nose. Around the 19th century, some people started to want to change their nose

because certain nose shapes were allegedly more desirable. This desirability had racial undertones

The public considered straight or small noses, for example, as more refined and attractive

while more prominent or curved noses suggested a cunning look or a lack of moral character

This being the case, members of some ethnic populations that were tarnished with such

stereotypes, such as European Jews, began to get nose jobs to make them look more American

The first nose job for cosmetic purposes did not occur until the late 1800s

but the procedure became common for Hollywood actors and actresses around the 1930s

and it only got more popular from there. In fact, by the year 2000

over 400,000 Americans had nosed jobs annually. Since then, however, the number has fallen

according to MarketWatch, with only around 225,000 Americans undergoing the procedure each year