The History of Rhinoplasty ① — When did nose surgery actually begin?

Say “rhinoplasty” and most people think of it as a modern technique.

The written record of nose surgery, though, goes back far further than that.

The oldest surgical document known to us is the Edwin Smith Papyrus.

It is thought to have been written around 1650 BC, and there is a view that it is itself a copy of an older original.

The document records forty-eight cases of trauma, and four of them concern the nose.

What I find most interesting is the way it handles a fractured nose.

It tells the surgeon to return the broken, deviated nose to its place, clean out the inside of the nose, pack it with linen soaked in oil, and hold it from the outside with a splint.

This is a record from 3,600 years ago. And it is not far at all from the principle by which we treat a nasal fracture today.

Return what has been displaced to where it belongs, and support that place from the inside and the outside. Only the material has changed — from linen to a modern splint and packing.

There is one more passage that stays with me.

For every case the document gives a diagnosis and then sorts it into one of three categories: an ailment I will treat, an ailment I will contend with, and an ailment not to be treated.

Which is to say the physician had already drawn a line between what he could do and what he should not do. That passage stayed with me for a long time.

Even now, the hardest judgement in the consulting room is not “how should I operate” but “should this be operated on at all.” A physician 3,600 years ago was standing in front of the same question.

Nose surgery did not set out from beauty. Letting someone breathe, and putting things back where they had been. That was the whole of it.

— Dr. Kim Hyung-taek, KOWON Plastic Surgery