19th century rhinoplasty was an improvement over methods of prior centuries. Experimentation with more complicated techniques, in general, proved more effective. However, with new technologies and risks came new complications.
A non-surgical nose reconstruction technique was developed for individuals with saddle nose deformity, a defect that causes a collapsed nasal dorsum. Using liquid paraffin wax to lift the dorsum, it was effective in achieving the desired look. The problem was that the technique had to be abandoned when the patients started getting paraffinoma, a cancer caused by the wax.
The ancient work of a physician named Sushruta, his work being preserved in his medical compendium the “Sushruta Samhita,” was still in use during the 19th Century. His work dated back to 800 BC. But, it wasn’t until the 1700’s that his work became known to European physicians.
In 1815, Joseph Constantine Carpue wrote about a rhinoplasty performed on a wounded soldier whose nose had been all but destroyed in battle, and another patient whose nose had been damaged by arsenic. His work, the “Account of Two Successful Operations for Restoring a Lost Nose” became somewhat of a standard for the time.
In Germany, rhinoplasty was further improved upon when “Rhinoplastik” was published by German professor of surgery, Karl Ferdinand von Grafe, in 1818. This work described 55 different plastic surgical procedures, including those stemming from India and other countries. To these, he added his own creative version that used a graft from the patient’s arm to reconstruct the nose.
A favored student of Professor von Grafe, Johann Friedrich Dieffenbach, was the first to use anaesthesia for nasal reconstructive surgery. He wrote “Die Operativge Chirurgie,” which translated to English means, “Operative Surgery,” in 1845. This became a standard text in the use of rhinoplasty.
Finally, looking to the United States in the 19th century, John Orlando Roe was the surgeon who performed the first endonasal rhinoplasty (meaning that the surgery was a closed rhinoplasty). He wrote about it in “The Deformity Termed “Pug Nose” and its Correction, by a Simple Operation” in 1887. He also discussed the correction of the condition of saddle nose.
