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 Surgery, and American plastic surgery, which had left the operation largely to otolaryngology, took it up. What he built around that paper mattered more than the paper: a course in Dallas that ran every year from 1984, a drawn record of every manoeuvre that made a rhinoplasty auditable, and a vocabulary of grafts that let surgeons in different cities describe the same operation.
What he changed
Four things that were different in American rhinoplasty afterwards.
He moved the open approach across a specialty boundary
Opening the nose through a columellar incision was fifty years old when Gunter published. Réthi described it in 1934, Šercer used it in Zagreb, his pupil Ivo Padovan brought it to the AAFPRS meeting in 1970, and Wilfred Goodman of Toronto published it in North America in 1973. It was, in Rohrich's account, "somewhat popular in facial plastic surgery but was not well appreciated, nor was it done well in plastic surgery before Jack Gunter." The 1987 paper on the external approach to secondary rhinoplasty put it in the plastic surgery journal of record, applied to the cases where visibility mattered most: noses somebody else had already operated on. The full chain of who did what first is on the history timeline and in the pioneers roster.
Rests on: Rohrich, Plast Reconstr Surg 2018 · Gunter and Rohrich, PRS 1987 (PMID 3602167) · Adamson and Gantous, Facial Plast Surg 2019 (PMID 31470461).
He made the operation teachable in a room, once a year, for forty years
The first Dallas Rhinoplasty Course ran in 1984, taught with his own professor and friend Robert Oneal, joined in the first years by Steve Byrd, John Tebbetts and Robert Sheffield, and by Rod Rohrich in 1986. It is still running: the 43rd meeting was held in March 2026, and its Jack P. Gunter Distinguished Lecture carries his name. Rohrich's count is that Gunter taught the operation to more than 10,000 plastic and facial plastic surgeons: a memoirist's figure, from the surgeon who inherited the meeting, and the only count anyone publishes. What is verifiable is the course, the dates and the faculty: they are on the Dallas meeting page.
Rests on: Rohrich, PRS 2018 · the meeting's own 2026 programme.
He made a rhinoplasty auditable
In 1989 he published the graphic record: a standard diagram on which the surgeon draws what was done to each part of the nose, in order. Before it, an operative note said "rhinoplasty performed"; after it, a revision surgeon could read what had been cut, grafted or sutured, and a course could compare two operations on the same terms. It is the reason the case reports of the 1990s stopped being anecdotes. The same instinct produced the 2006 paper fixing the nomenclature of rhinoplasty grafts (spreader, strut, batten, onlay, shield), so that a paper published in Dallas described the same object as a paper published in Istanbul.
Rests on: Gunter, PRS 1989 (PMID 2473481) · Gunter et al., PRS 2006 (PMID 16816668).
He argued the case in print against the best closed surgeon of the era
In March 1997 Plastic and Reconstructive Surgery printed the two papers back to back: Gunter, "The merits of the open approach in rhinoplasty", and Jack Sheen, "Closed versus open rhinoplasty — and the debate goes on". Rohrich, who watched both men at meetings, describes Gunter as "a rough-and-tumble challenger to Dr. Jack Sheen". Neither of them settled it. The current literature still compares the two approaches and still finds most of the difference is in what the surgeon can see rather than in what the patient gets. That comparison, in the papers published since, is on open versus closed.
Rests on: Gunter, PRS 1997 (PMID 9047209) · Sheen, PRS 1997 (PMID 9047208) · Rohrich, PRS 2018.
The record
| Date | What is documented | Source |
|---|---|---|
| 1937 | Born | PRS obituary title, "Jack Gunter, M.D., 1937 to 2017" |
| 1979 | Chief resident in plastic surgery, University of Michigan, the year Rohrich arrived as an intern | Rohrich, PRS 2018 |
| 1984 | First Dallas Rhinoplasty Course, with Robert Oneal | Rohrich, PRS 2018 |
| 1984–86 | Early faculty: Steve Byrd, John Tebbetts, Robert Sheffield | Rohrich, PRS 2018 |
| 1986 | Rohrich joins the Dallas faculty | Rohrich, PRS 2018 |
| 1987 | "External approach for secondary rhinoplasty", PRS 80:161–174 | PMID 3602167 |
| 1989 | The graphic record | PMID 2473481 |
| 1997 | "The merits of the open approach in rhinoplasty", printed opposite Sheen | PMID 9047209 |
| 2006 | Nomenclature of rhinoplasty grafts | PMID 16816668 |
| 2010 | Secondary rhinoplasty and autogenous rib cartilage, with Spencer Cochran | PMID 20206752 |
| 2017 | Died | PRS obituary title |
| 2026 | 43rd Dallas Rhinoplasty Meeting; the Jack P. Gunter Distinguished Lecture continues | PR Newswire, 2026 |
His own rule, quoted by Rohrich: never leave the operating room until the nose appears as good as it can.
What is disputed
- The first Dallas course is dated 1984 in Rohrich's memoir. The meeting's own numbering, 43rd in 2026, implies 1984 counted inclusively, and press material has been read as implying 1983. This site uses 1984, the primary source.
- "Over 10,000 surgeons taught" is Rohrich's figure in a memoir for a friend; the meeting's own material now says "tens of thousands" across its whole history. Both are the organisers' numbers and neither is independently auditable.
- Priority for the external approach is not Gunter's and this page does not claim it. Réthi 1934, Šercer, Padovan 1966–70 and Goodman 1973–74 precede him; the disagreements about that chain are set out on the history page.
The papers this rests on
- Gunter JP, Rohrich RJ. External approach for secondary rhinoplasty. Plast Reconstr Surg 1987;80:161–174. PMID 3602167
- Gunter JP. The graphic record. Plast Reconstr Surg 1989. PMID 2473481
- Gunter JP. The merits of the open approach in rhinoplasty. Plast Reconstr Surg 1997. PMID 9047209
- Sheen JH. Closed versus open rhinoplasty, and the debate goes on. Plast Reconstr Surg 1997. PMID 9047208
- Gunter JP, Landecker A, Cochran CS. Nomenclature of rhinoplasty grafts. Plast Reconstr Surg 2006. PMID 16816668
- Cochran CS, Gunter JP. Secondary rhinoplasty and the use of autogenous rib cartilage grafts. Clin Plast Surg 2010. PMID 20206752
- Rohrich RJ. Jack Gunter, M.D.: a man of passion and a true friend, with some of his own words. Plast Reconstr Surg 2018;141(2):537–540.
- Adamson PA, Gantous A. The history of the open approach. Facial Plast Surg 2019. PMID 31470461
Written by rhinoplasty.cc from the sources linked above, 2026-09-09.