Surgical nose jobs have a quite long and distinguished history as a reconstructive procedure of far more than two thousand years if Indian sources a taken as a reference. The birth of rhinoplasty for cosmetic purposes took place in Berlin after World War I and is detailed in Jacques Joseph’s book “Nasal Plastic Surgery and other Facial Plastic Surgery Procedures”, a true milestone in plastic surgery in general and surgical
nose jobs in particular.
But it was only in the past three decades that the operative techniques of of surgical nose jobs have
experienced the revolution that resulted in the contemporary, natural rhinoplasty performed by rhinoplasty surgeons worldwide. The results are more natural, longer lasting and fraught with far fewer complications than in those maybe not so good old days.
Joseph’s original surgical nose job technique was primarily a reduction of the nose in all its dimensions. Joseph developed many of his techniques in response to the problems which confronted him. And these problems were primarily big, wide and long noses with humps of considerable proportions as well as wide, often bulbous tips. A rhinoplasty according to Joseph aimed to reduce all of these exaggerated features. As a
consequence of the emigration of surgeons from Germany prior to World War II, Joseph’s surgical nose job techniques were spread widely over the western hemisphere. These techniques were certainly not trivial, but
from a surgical standpoint not particularly difficult either, because they aimed to do something all surgical specialties are good at: cut something out, remove something, make it shorter, smaller etc.
Unfortunately noses do not have a lot of tolerance as far as excessive reduction of
any of its components during rhinoplasty is concerned. This is again similar to a house. Once too many of the important beams, gables or other structurally important parts of the framework are cut, weakened or
removed, the house generally collapses. The exactly same thing may happen when a surgical nose job whittles away more and more of the beams and structurally important parts of the framework of the nose. The
collapse is not evident immediately as the skin needs time to shrink and the load bearing parts now deprived of stability are pulled down by scar and strain. So often the results do not look bad after nose job
surgery, but the collapse due to excessive reduction becomes evident over a couple of months. The infamous “over operated” look results. The bridge is too low, the tip too pointy, turned too far upward without a
real distinctive break between bridge and tip. More often than not patients breathe with more difficulty after the nose job surgery than before. Only a select few of the best rhinoplasty surgeons can reliably
correct an “over operated” nose resulting from rhinoplasty with excessive reduction and subsequent instability of the framework of the nose.
Modern surgical nose jobs achieve more natural results, noses which are more in harmony with the face, noses through which patients can breathe well and most importantly can avoid complications and re operations to a much greater extent than ever before.