The history of rhinoplasty
The Sushruta cheek flap, the Branca and Vianeo arm flap, Tagliacozzi 1597, the Cowasjee case of 1793, Roe 1887 and Joseph 1898, then Skoog, Sheen, Gunter, Toriumi and preservation. 65 dated entries and 82 pioneers, each with its journal citation.
- Meeting1967 – 2026
The Baker Gordon Symposium
In February 1967, two Miami plastic surgeons held a meeting about aesthetic surgery because the specialty's own organisations would not, and put live operations on the programme. It was the …
Open - Meeting1984 –
The Dallas Rhinoplasty Meeting
For four decades the way an American surgeon learned rhinoplasty was to go to Dallas in the spring: Jack Gunter and Robert Oneal started the course in 1984 to teach the open approach, and it…
Open - Timeline3000 BCE – 2026
History of rhinoplasty - the timeline
Nasal reconstruction is the oldest operation in plastic surgery: it begins with amputation as punishment, the Sushruta Samhita's cheek flap and the Indian forehead flap, passes through the B…
Open - Surgeon1937 – 2017
Jack P. Gunter, MD
A Hungarian surgeon described the open approach to rhinoplasty in 1934 and a Croatian school carried it through the 1960s. In 1987 Jack Gunter published it in Plastic and Reconstructive Surg…
Open - Surgeon1925 – 2021
Jack H. Sheen, MD
Jack Sheen turned rhinoplasty from an operation about removal into an operation about replacement: his 1984 spreader graft rebuilt the roof of the middle vault that hump removal had taken aw…
Open - Roster600 BCE – 2021
The pioneers of rhinoplasty
Eighty-two entries, from Sushruta's cheek flap around 600 BCE to piezoelectric preservation in 2021, and almost none of these people were plastic surgeons as the term is used now: Ayurvedic …
Open
The timeline
Sixty-five dated entries, 3000 BCE to 2026. Each names the journal, book or newspaper that carries it; none rests on Wikipedia. The people are in the pioneers roster.
- c. 3000-2500 BCE
The Edwin Smith Papyrus
The oldest written nasal surgery: treatment of the broken nose, in an Egyptian surgical papyrus.
- c. 1500 BCE
Nasal amputation in the Ramayana
The poem refers to reconstruction after the amputation of Surpunakha's nose. Amputation as punishment is what created the demand for the operation.
- c. 1000-600 BCE
Sushruta: the cheek flap
A creeper leaf as template, a flap “sliced off from down upward, from the region of the cheek,” and reeds to stent the nostrils.
- c. 25 BCE-50 CE
Celsus, De Medicina
Repair of facial defects by advancement of adjacent skin. Hippocrates and Galen precede him on nasal fracture.
- c. 600 CE
Vagbhata adds the lining
The flap folded on itself to line the inside of the new nose.
Source: Shaye 2021
- 980-1037
Avicenna sets the septum
A stylus in the nasal cavity to refracture and straighten, then packing. The deviated nose is bandaged with linen soaked in fish glue.
- c. 1300
Henri de Mondeville
Local advancement flaps for nasal loss, at the medical school of Montpellier.
Source: Marinozzi 2021
- from 1440
The Kanghiari family of Khanga
Hereditary nasal reconstruction in Punjab, with a patient registry and signed consent. Sons and daughters-in-law were taught; unmarried daughters were not, so the craft could not leave the family by marriage.
Source: Shaye 2021, citing Almast 1967
- by 1450
Antonio Branca moves to the arm
Gustavo Branca rebuilt the nose from the cheek; his son took the skin from the arm “so that no distortion of the face should be caused” — the Italian method.
- 1502
Benedetti puts it in print
Alessandro Benedetti records the arm flap in the medical literature, noting the new nose does not tolerate hard winters and sometimes grows hair.
- 1540-1565
The Vianeos of Tropea
Paolo and Pietro Vianeo operate publicly in Calabria. Greco argues the Vianeos preceded the Brancas rather than followed them.
Source: Greco, Ann Plast Surg 2010
- 1517-1588
Fioravanti breaks the secret
Leonardo Fioravanti watches the Vianeos operate and prints the method in the vernacular Books of Secrets.
- 1597
Tagliacozzi, De Curtorum Chirurgia
The first book devoted to plastic surgery, with the operation, the instruments and the plates. “We restore, rebuild, and make whole those parts which nature hath given, but which fortune has taken away.”
- 1742
Paris bans the operation
After Tagliacozzi's death the arm flap is abandoned for nearly two centuries. The Faculty of Paris prohibits it.
Source: Marinozzi 2021
- 1767
Kirtipur: 865 noses
The Gurkha king orders the nose cut from every male in the town, sparing only the unweaned and players of wind instruments. It is afterwards called Naskatapoor, the city without noses.
Source: Shaye 2021, citing Whelpton 2005
- 1793
Cowasjee
A bullock driver for the English in the Third Mysore War loses his nose and hand on the order of Tipu Sultan. An unnamed Maratha healer rebuilds the nose with a forehead flap; two East India Company surgeons report it in the Madras Gazette.
Source: Shaye 2021, citing Brain 1988
- October 1794
The Gentleman's Magazine letter
A letter signed “B.L.” describes the Indian forehead flap for London: wax as template, and “a small slit between the eyes. This slit preserves the circulation until a union has taken place between the new and the old parts.”
Source: Gentleman's Magazine 1794; Freshwater, Plast Reconstr Surg 1972
- 1814
Carpue in England
Joseph Constantine Carpue, after studying the reports and practising on cadavers, performs the first Indian-method rhinoplasty in Europe. Taking the dressing off on the third day he said: “My God, there is a nose!”
Source: Shaye 2021
- 1816
Carpue publishes
An Account of Two Successful Operations for Restoring a Lost Nose carries the technique across Europe and America.
Source: Carpue 1816; Plast Reconstr Surg classic reprint 1969
- 1818
Von Graefe coins Rhinoplastik
Karl Ferdinand von Graefe publishes Rhinoplastik in Berlin and describes the free-graft German method.
- 1838
- 1840
Liston argues for it in public
“Prejudice against rhino-plastics would rapidly thaw before the warmth of aroused feelings of humanity.”
- 1845
Dieffenbach reduces a nose
Die Operative Chirurgie: the first attempt to make a prominent nose smaller, by external incision and soft-tissue resection.
- 1863-1900
Framework enters the nose
Ollier's osteoplasty (1863), Konig's forehead skin-periosteum-bone flap (1886) and von Mangoldt's costal cartilage for the saddle nose.
Source: Reference list, Shaye 2021
- 23 April 1880
The press gets there first
The Daily Register reports a New York surgeon turning a pug nose into “a very respectable nose of the Roman type” — seven years before the medical literature.
Source: Zhang 2026
- 1887
Roe: the first cosmetic rhinoplasty
John Orlando Roe of Rochester publishes The deformity termed pug nose and its correction, by a simple operation. It is done entirely inside the nose.
- 1891
Roe takes the hump
Correction of the angular nasal deformity by a subcutaneous operation: the first endonasal hump reduction.
Source: Marinozzi 2021
- 1892
Weir
On restoring sunken noses without scarring the face, and a duck sternum implanted in a syphilitic patient's nose. The alar base wedge is still the Weir incision.
- May 1898
Jacques Joseph, Berlin
Joseph presents a reduction rhinoplasty to the Berlin Medical Society with the argument that a disfigurement causing social or economic disadvantage is a disability. He called the wish to look normal anti-dysplasia, not vanity.
Source: Gupta, Indian J Plast Surg 2009
- 1899
Goodale: the push down
Lateral and radix osteotomies with the vault mobilised intact — dorsal preservation, 119 years before it was named.
- 1902-1904
Killian and Freer
Submucous resection of the septum becomes standard.
- 1904
Joseph goes intranasal
Joseph publishes intranasal hump correction combined with correction of the anterior septum.
- 1914
Lothrop: the let down
The first let-down operation, in the same Boston journal that carried Goodale.
Source: Lee and Toriumi 2021
- 1914-1918
The war makes the specialty
Nineteen surgeons found modern craniofacial practice on the wounds of the First World War: Gillies at Sidcup with the tubed pedicle flap, Morestin, Kazanjian, Blair, Filatov, Suzanne Noel and Joseph among them.
Source: Treger, J Craniofac Surg 2025
- 2 June 1916
Joseph at the Charite
Wilhelm II had offered Joseph the chair on condition he convert from Judaism; he refused. The ministry gives him an unpaid department instead. Professor in 1919, and the Iron Cross.
Source: Gupta 2009
- 1922-1935
Augmentation reaches East Asia
The Nose Lifter clip is sold to Korean women in 1922; Nishihata and Yoshida publish ivory augmentation in Japan in 1923; the operation is common in Korea by 1927. Injection augmentation is thought harmless until 1935.
- 1926
Sebileau and Dufourmentel
The French inferior-strip technique lowers the dorsum without removing it.
- 1928-1931
Joseph's textbook
Nasenplastik und sonstige Gesichtsplastik nebst Mammaplastik: 842 pages, 1718 illustrations, published in parts and completed in 1931.
Source: Gupta 2009
- 12 February 1934
Joseph dies
Restricted by the Nazi authorities to a few approved procedures, Joseph dies of a heart attack in the hallway of his house. The German medical press does not mark it; obituaries appear only abroad.
Source: Gupta 2009
- 1934
Rethi opens the tip
The high transcolumellar incision: the first step toward the open approach.
- 1930s-1940s
The operation reaches America
Gustave Aufricht and Joseph Safian, both trained at Joseph's table, take it to New York. Samuel Fomon starts his teaching course in 1940; Maurice Cottle starts his in 1944.
Source: Safian, Plast Reconstr Surg 1970
- 1946
Cottle's inferior strip
Cottle modifies the French preservation technique, and replaces submucous resection with septoplasty.
- 1956
Sercer: decortication
In Zagreb, Ante Sercer extends Rethi's exposure to the whole nasal pyramid.
Source: Rev Laryngol Otol Rhinol 1957
- 1957
The Goldman tip
Irving Goldman divides and reconstitutes the medial crura for tip projection.
- 1966
Skoog puts the hump back
Tord Skoog resects the nasal roof and replaces it: the ancestor of the autospreader and of the whole preservation argument.
- 3-4 February 1967
Baker Gordon Symposium, Miami
The first US meeting devoted to aesthetic surgery and the first national meeting with live surgery. The American Society for Aesthetic Plastic Surgery forms out of it.
Source: Baker Gordon 2026 program
- 1970
Padovan brings the open nose to America
Sercer's pupil Ivo Padovan presents the external approach at the First International Symposium of the AAFPRS. Jack Anderson publishes the tripod concept of the tip the same year.
- 1973-1974
Goodman in Toronto
Wilfred Goodman, the first North American to adopt the external approach, publishes it twice.
- 1975
Sheen turns to grafting
Secondary rhinoplasty: the operation moves from removal toward replacement. Dorsal and tip grafts are shown at the Millard Symposium the same year.
- 1978
- 1984
The spreader graft
Sheen rebuilds the roof of the middle vault after hump removal: the graft that made reduction survivable.
- 1984
The first Dallas Rhinoplasty Course
Jack Gunter and Robert Oneal begin teaching rhinoplasty to American plastic surgeons.
- 1985
Burget and Menick: the subunit
The nose read as a set of subunits defined by light and shadow. It still governs reconstruction.
Source: Burget and Menick, Plast Reconstr Surg 1985;76:239-247
- 1987
Gunter and Rohrich in PRS
The external approach for secondary rhinoplasty: the operation crosses from otolaryngology into US plastic surgery.
Source: Gunter and Rohrich, Plast Reconstr Surg 1987;80:161-174
- 1994
Tebbetts sutures the tip
Shaping and positioning the nasal tip without structural disruption: suture instead of excision.
- 1997
Open versus closed, in print
The two schools argue it out in Plastic and Reconstructive Surgery. The Rhinoplasty Society is founded the same year, with Jack Sheen as its first president.
- 2002-2005
Toriumi codifies structure
Build the framework, then drape the skin: the structure approach, with lateral crural strut grafts and repositioning.
- 2004
Component dorsal hump reduction
Rohrich takes the hump apart rather than off in one pass, to keep the dorsal aesthetic lines.
- 2012
Cakir preserves the envelope
Complete subperichondrial dissection: preserve the soft tissue, not only the bone.
Source: Cakir, Aesthet Surg J 2012
- 2015-2018
The anatomy behind preservation
Palhazi, Daniel and Gerbault re-describe the osseocartilaginous vault, the nasal ligaments and the bony vault.
Source: Palhazi, Aesthet Surg J 2015
- 2017
Jack Gunter dies
“He is directly accountable for teaching over 10,000 surgeons.”
- 2018
Preservation rhinoplasty is named
Saban reassesses the push-down and Rollin Daniel names the movement: The Preservation Rhinoplasty, A New Rhinoplasty Revolution.
- 2021
Piezo, and the death of Jack Sheen
Goksel publishes piezoelectric osteotomy in preservation rhinoplasty. Sheen dies on 19 April 2021, aged 96.
- 2022-2024
Toriumi hybridises the schools
Structural preservation rhinoplasty, then a direct comparison of dorsal preservation against structural technique.
- 2026
A decade of preservation; Baker Gordon ends
Preservation Rhinoplasty: A Decade of Progress and Technical Refinement. The 60th and final Baker Gordon Symposium runs 5-7 February 2026; the Dallas meeting turns 43.