RHINOPLASTY – Profilo Salute magazine, June 2015

In many people’s minds, rhinoplasty is the first procedure that you think of when talking about cosmetic surgery. With rhinoplasty, it is possible to correct small and large imperfections of the nose which are sometimes a source of discomfort for many people.
The history of this procedure is unexpectedly ancient if we think that in India in 2000 a. C. a technique was introduced, which is still known today as the Indian flap, for the reconstruction of the nasal pyramid which, in that civilization, was amputated on prisoners of war.
In the Renaissance period, explicit reference is made to cosmetic surgery for the first time in reference to the possibility of reconstructing mutilated noses from syphilis. Heinrich Von Pfalzpaint, who lived between 1400 and 1465, proposed a technique for the reconstruction of the nose through the use of skin flaps taken from the arm. In 1597 Gaspare Tagliacozzi, from Bologna, wrote the “de curtorum chirurgia per insitionem” in which he relates the social discomfort and the unhappiness of patients suffering from syphilis with deformed nose, proposing a surgery repairing the aesthetic damage. Similarly, the Branca family active in Catania in the fifteenth century performed the reconstruction of the nose with cheek and arm flaps. A further development of nasal pyramid surgery took place in India at the end of the 18th century by the English surgeon C. Lyon Lucas until the German J. F. Dieffenbach in 1834, definitively laid the foundations of modern rhinoplasty.
Through small incisions made inside the nostrils which were then externally invisible, the surgeon can correct many defects: a bump or a low bridge, nostrils that are too wide, a tip that is too large, a nose that turns down or up too much.
Unlike what is commonly thought, rhinoplasty is a completely painless surgical procedure, especially when performed with aesthetic purposes; the minor discomforts resulting from the procedure are related to social presentability in the days following the procedure. In fact the patient wears a splint on the nasal bridge for about a week and often presents swelling and bruises in the eyelid region. This operation is usually performed under general anaesthesia or under sedation as a day case or with a very short hospitalisation. Small tip corrections can be performed under local anaesthesia with immediate discharge.
Next to the aesthetic indications, when necessary, are associated functional ones for which a deviation of the nasal septum or a hypertrophy of the turbinates can be treated during aesthetic rhinoplasty or, conversely, the functional need may be an opportunity to correct aesthetic defects which, in themselves, would not have been sufficient to lead the patient by the surgeon.
Aesthetic rhinoplasty is, par excellence, a transformational procedure. In fact, the patient asks for a change to their own physical appearance and, precisely by virtue of this consideration, it is fundamental that the shape and the volume of the nose are the result of a careful evaluation of the face as a whole in order to produce an absolutely harmonious result.
“A nose is beautiful when it’s invisible”. When you look at someone’s face and the nose isn’t immediately noticed, whether beautiful or ugly, it has characteristics that can be considered harmonious in the context of that face.