The History of Rhinoplasty Surgery in Dubai & Abu Dhabi | UAE

Rhinoplasty has always been unique in its place in cosmetic surgery as it is and always has been a functional and cosmetic procedure. Unlike most cosmetic procedures that have been in place really only in the last century rhinoplasty was first described in 600 BC! In India at that time the nose was removed as punishment for some crimes, especially adultery Non Surgical Nose Reshaping Dubai.

Clearly the deformed nose was planned to serve as a warning to others. A surgeon Sushata Samhita pioneered a technique of swinging a flap of skin down from the forehead to refashion the nose. This technique is still in use today for nasal reconstruction following trauma or surgery.

Columbus' fleet returned from the New World with tobacco and syphilis. The latter commonly affected the nose and caused a collapse or 'saddle nose' deformity. This is seen now days post trauma and gives the appearance of a 'boxers nose'. A connected forearm flap was first described by Heinrich von Pfalzpaint in 1460 and further developed by Gaspare Tagliacozzi in 1597.

The Catholic Church didn't much like that people were correcting the 'visible sin of syphilis' and the work of Tagliacozzi was ignored, lost or forgotten through the subsequent centuries and it wasn't until an Indian in the service of the British was captured by a rebellious Tipi Sultan in 1794 and as punishment had his hand and nose amputated. His nose was reconstructed using a pedicled forehead flap.

One must remember that anaesthesia was not developed until 1847 and antisepsis in 1867. Before this time any surgery would have been excruciatingly painful, and at high risk of failure due to infection. The other big development of the 19th century was the work of one man Johann Freidrich Dieffenbach from Berlin. He was central to the development of facial surgery. The social stigmata of crime in India and disease in Europe had until now coerced patients into painful and dangerous procedures. But these new developments allowed Dieffenbach to experiment and pioneer multiple nasal procedures.

In 1887 the first intra-nasal rhinoplasty was performed by John Orlando Roe in 1887. And this closed technique would continue for almost a century as the preferred procedure. The final, more philosophical development that aided cosmetic surgery of the nose in the 19th century was the Enlightenment philosophy. The concept that happiness was a viable aim in life, and that you can make yourself happy by being able to actively participate in the world. Indeed it is remarkable how often aesthetic surgeons describe happiness as the goal of surgery.

The wars of the first half of the 20th century were remarkable in the development of surgical technique and the development in other fields of medicine such as respiratory and sleep medicine, allergy and sports medicine increased the focus on the nose not just as a aesthetic but also as a functional organ. As a consequence the focus of rhinoplasty also improved to include assessment and treatment of reduced nasal airway, snoring and sinusitis, allergy and smell problems.

in 1973 Wilfred S. Goodman published an article as the merits of 'open' or external rhinoplasty. This is where a small incision is made between the nostrils for better access to the nose, in particular the tip. Jack Anderson and Jack P. Gunter further popularised this open technique, especially in revision or difficult cases.

The style of rhinoplasty has also changed in the last 20 years. In the 80s and early 90s a somewhat 'cookie-cutter' technique was often applied, with great sameness of outcome for all patients. Over-resection was also very common both in the dorsum or bridge and in the alar (nostril) cartilage. This may have provided a desirable result initially but often deteriorated over time to give a very artificial appearance.

Today in the 21st century, rhinoplasty is still an evolving procedure. Techniques are always developing, and the advent of better pre-operative assessment, with tools like computer imaging and post-operative care with techniques like post-op refinement fillers and steroids means that results are always improving. The philosophy of rhinoplasty is also changing with the concept of a different nose for every patient, and care to address functional problems at the same time.