Rhinoplasty History

Nose Jobs (Rhinoplasties) are nothing new in the world; they were first performed 2500 years ago by an Indian doctor called Sushruta (below, tending to a patient).

Ancient Nose Reconstructions

We believe that these early Indians had their noses cut off for a crime that had something to do with their attractiveness or beauty that they used to their advantage. Since most cultures, even today, have very strong rules and punishments for illicit sex, it makes sense that these nose amputations were not meant to act only as a punishment, but also a deterrent for future transgressions. It’s ironic that adultery was probably the seed that created the modern reconstruction of the nose because today, most rhinoplasties are done by people motivated to look better for the opposite sex. According to figures published  by ASPS and AAO-HNS, it is estimated that almost a half million rhinoplasties are performed each year in the US mostly because many of us do not like the nose with which we were born.

Genetic Origins of Noses

Iranian Woman with Recent Rhinoplasty

Genetic studies have shown that all species develop certain physical attributes based upon natural selection. For example, there are some birds in Galapagos that share a common ancestry with other species of birds in South America, but because of a physical separation from the mainland, over thousands of years, they developed beaks that were more useful for the environment found in Galapagos. Some of these beaks were more pointed, or more blunt, or bigger, all depending upon the food sources available in the islands of Galapagos.

Like other species on this planet, the human nose has evolved in many different shapes depending usually upon climate. Indeed, bigger curved noses developed in cultures where breathing at a high altitude or breathing dry air at low altitudes was more effective to moisturize the air before it entered the lungs. An example of this are the Mayas and Incas who lived in high altitudes, as well as the cultures around the Himalayas such as the Afgans and Persians.

In cultures with larger curved noses, like Iran, a rhinoplasty today is as common as breast augmentations in the US (one of every 50 Iranians have a nose job). Interestingly, this phenomenon is due to the westernization of Persians (more specifically due to the exportation of American culture via Hollywood), something they have a hard time to admit because of the current political atmosphere.

Iranian Woman After Rhinoplasty

Medical/Health Origins of Larger Noses

A larger wider nose with bigger nostrils is more effective to cool down the air that flows through the nasal passages and thereby cools the head during strenuous exercises. Therefore, in hot climates, the nasal openings need to be bigger and or larger like the African nose. In cooler climates the nostrils are smaller to prevent the loss of heat. There are exception however, like our distant cousins the Neanderthals who died out 25,000 years ago and were well adapted to colder climates and had large noses rather than smaller ones because of the physical exertions required for hunting in very cold climates where sweating less in freezing conditions was advantageous for survival in an Ice Ages environment. To summarize, there are 3 known factors for having developed larger noses: physical activity, ambient temperature, and the dryness of the surrounding air. A large curved nose can help cool or moisturize the air before it goes down to the lungs. So,  for example, if you are a ski instructor living in Aspen, Colorado, you should think twice about having a rhinoplasty to reduce the curvature of your nose because  it might be slightly helpful to physical performance in your profession.

Then, there are medical reasons why noses needed to adapt to climate. The nose is the lungs’ first line of defense, where particles larger than 10 microns in size (that’s about ¼ the diameter of a human hair) will be trapped and transported to the oropharynx where they can be ejected from the body either by sneezing, blowing your nose, or spitting out the mucus that carried these particles down to the throat. This function only operates well if the ambient moisture of the nose is optimal and therefore, the size of the nose is important to maintain the correct level of humidity within the nose to maintain this function.

Summary

The size of our noses is determined by heredity. The size of our ancestors' noses was determined by natural selection based upon the climate where they lived and their physical activity. Today, because we are protected from both extremes in cold, dryness, and physical activity, there is not much use for a larger or more curved nose.  There are always rare exceptions to this rule. For example, if your hobby is mountain climbing, and one day you plan to conquer Mount Everest, you should seriously put off having a rhinoplasty until retirement.