The History of Rhinoplasty ⑦ — Jacques Joseph, and an age when the shape of a nose became a mark

The name most often called the father of modern rhinoplasty is Jacques Joseph of Berlin (1865–1934).

In May 1898 he reported a case to the Berlin Medical Society.

It was a male patient who had been suffering under people’s stares because his nose was held to be too large.

Joseph practised first on the nose of a cadaver before operating, and the result was a success.

Here I want to correct something that is commonly got wrong. The 1898 operation cut the outside of the nose, and it left a scar.

Joseph did not publish hump correction through an incision inside the nose until 1904.

Which is to say the first to publish the closed, non-open approach — going in from inside the nose — was not Joseph but Roe, introduced above, and Joseph appears not to have known it.

It is said there was later some bad feeling between the two men over priority.

Even so, there is a separate reason Joseph is called the father.

In his 1898 report he also put forward the view that the psychological effect of aesthetic surgery matters as much as the physical result.

It was an early attempt to give a medical account of what changing an appearance does to a person’s mind and life.

There is the weight of an age in this. Joseph himself was a Jew, born the son of a rabbi, and in the Germany of that time the shape of a nose was treated as something like a mark identifying a Jew.

A good many of his patients were people from Berlin’s Jewish community. There is testimony that he operated without charge on anyone he judged to be suffering because of a “Jewish nose.”

He died in 1934. What happened after that, we know.

I find it hard to read this story as simply a good one.

The gaze that lets a single nose define a person’s identity came first, and the surgery was a choice made to escape that gaze.

Was it the nose that needed to change, or the way society looked?

A hundred years have passed, and I do not think it is entirely someone else’s story even now.

There are times in the consulting room when I hear, “because of this nose, people see me a certain way.”

It leaves a bitter taste.