Rhinoplasty

Rhinoplasty, from Ancient Greek ῥίς (rhís), meaning "nose", and πλαστός (plastós), meaning "moulded", commonly called nose job, medically called nasal reconstruction, 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 can also treat 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.^{[citation needed]} Surgery only on the septum is called a septoplasty.

In closed rhinoplasty and open rhinoplasty surgeries – a plastic surgeon, an otolaryngologist (ear, nose, and throat specialist), or an oral and maxillofacial surgeon (jaw, face, and neck specialist), creates a functional, aesthetic, and facially proportionate nose by separating the nasal skin and the soft tissues from the nasal framework, altering them as required for form and function, suturing the incisions, using tissue glue and applying either a package or a stent, or both, to immobilize the altered nose to ensure the proper healing of the surgical incision.

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.