The History and Evolution of Rhinoplasty

Perhaps we can think that Rhinoplasty, like many other techniques within plastic, aesthetic and reconstructive surgery, is something recent, modern, of our current time. However, the history of this specialty, certainly one of the most complex, dates back many centuries.

Around 2500 years BC in places like India and Egypt began to perform important repairing (reconstructive) nose operations.

In this period one of the figures of reference is the Hindu doctor Sushruta, author of the book SushrutaSamhita, a text where around 300 surgical procedures are mentioned.

The best known contribution of Sushruta to Plastic Surgery has to do with the reconstruction of the nose, this procedure was applied in people who had lost the nasal appendix because of participating in battles or receiving sentences (by thieves or criminals) that included as punishment the amputation of the nose.

One of the techniques Sushruta documented was to take a piece of tissue from the forehead to perform nasal reconstructions. This technique, saving the distances, is still used in Reconstructive Rhinoplasty operations.

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We must take a leap of many centuries and advance until the end of the 19th century when the great challenge of the artistic modification of the nose at an aesthetic level begins to be faced and, therefore, the foundations of Rhinoplasty as it is known today are laid. in day. In this sense, the first to perform nasal reduction surgeries through external incisions was: Johann Dieffenbach.

The first data on operations carried out under Dieffenbach’s scientific rigor date from 1845, in fact his book was one of the first publications that defined the treatment of the nasal tip and hump through external incisions.

The American plastic surgeon John Orlando Roe, advanced a step further in the intervention by making incisions inside the nose, in 1887 . In addition, preoperative and postoperative photographs were also introduced for the first time.

Later, Jacques Joseph, in 1904, was the one who systematized the steps of the Roe technique, laying down the roots of modern aesthetic rhinoplasty. In fact, most of the surgical equipment used today for the procedure was developed by himself.

The challenge of improving rhinoplasty passed to Dr. Emile Rethi , in 1934, whose open rhinoplasty technique places the incision in the middle of the columella, to improve the visibility of the cartilages of the nasal tip.

Along the s. XX the surgical techniques were evolving, progressing more and more in the improvement of more and more specific aesthetic aspects. In this sense, Rhinoplasty ceases to be a mere aesthetic improvement to also seek a functional respiratory result (Killian 1905). It was precisely the concepts of Anderson’s tripod , about the support of the tip (1982), which laid the foundations for the modifications in the nasal tip, always preserving its firmness and structure.

And a long list of illustrious plastic surgeons appeared who, with their contributions, notably increased the arsenal of techniques and technical resources in favor of a more complex but also more precise rhinoplasty with better results. Cartilage grafts appeared among other resources.

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However, the most significant advances can be seen in the last 30 years, where the search for a natural result has been the main line of work. Among these new advances and techniques is that of Doctor Rodríguez-Camps. His outstanding doctoral thesis Cum Laude ‘A New Technique for Remodeling the Nasal Tip in Rhinoplasty, for Extremely Difficult Cases, Through Total Resection of the Alar Cartilages and Temporal Fascia’ has been the subject of dissemination in magazines and books of international circulation, as well as in National and International Congresses. And it is that to date there were no similar procedures in the history of Plastic Surgery.
According to the Doctor: ‘The treatment of the nasal tip is surely the most complex of Rhinoplasty. And if the tip is especially difficult, the rhinoplasty is more complicated. ‘ His technique, which is carried out at the Rodríguez-Camps Clinic, is totally innovative worldwide, and is based on the refinement and beauty of the nasal tip in highly complex cases such as broken, asymmetrical, distorted, wide, globular tips. or flattened.

Revolutionary in her field, leaving aside prejudices and taboos, both anatomical and functional, historically inherited ; This procedure removes all the cartilaginous structure of the malformed or destroyed vertex to replace it with soft tissue (temporal fascia). So you get a smooth nasal vertex, to the eye and to the touch.