Saturday, April 16, 2016


     There was no shortage of fashionistas in the 16th century,

but cosmetic surgery was unheard of  - with one exception.  Physicians performed rhinoplasties - otherwise known as nose jobs - although I'm using that term in a misleading way.  We're talking about full nasal reconstruction procedures, not small tweaks.  Men of that era tended to have a nasty habit of lopping each others' noses off during duels and swordfights.  In fact, that's what happened to Tycho Brahe (1546-1601), the renowned Danish astronomer, who lost most of his nose in a duel and for the rest of his life wore a metal (some say silver) prosthesis over it.  And diseases like cancerous tumors and syphilis did their fair share of nasal damage too.
     But the history of cutting off someone's nose to punish or humiliate them goes back much farther than the medieval era.  An article by plastic surgeon Larry Nichter, M.D., provides the following information:

     Examples abound in Asian and European literature. In the ninth
     century the Danes slit the noses of Irishmen who could not pay
     the annual levied tax of one ounce of gold. Sixtus Quintus of
     Rome (1521–1590) ordered nasal amputation of thieves and
     other rogues. In 1769–1770 Pritivi Narayan, the Ghoorka King
     of India, ordered the amputation of nose and lips of all 865 male
     inhabitants in the recently captured city of Kirtipoor, Nepal. Only
     musi­cians who played wind instruments were ex­cluded. Adding
     insult to injury, he changed the city’s name to Naskatapoor, which
     means “city without noses.”15 In recent times, too, the Da­coits of
     Northern India plundered a village and punished resistance by
     amputating the noses of their enemies.

Nichter also says that in India, mutilation of the nose was practiced "on women suspected of infidelity, on sexual offenders, and as a prime means of 'mortal revenge.'"  Because nasal mutilation was not uncommon in that country, it's thought that the practice of nasal reconstruction originated in India.  The first detailed description of nasal replacement is found in a classical Indian text written in about 600 B.C.  The method employed was removal of a flap of skin from the patient's cheek, attaching it to the bridge of the nose to maintain a blood supply, sewing it in place over the nose area, and binding it all together with bandages until healing was complete.  At some later point, the "Indian method" of nasal reconstruction came to involve the use of a flap of skin from the middle of the patient's forehead, rather than from his cheek.

     Gradually, Indian medical knowledge spread to the West.  In 15th-century Italy, the Branca family of Sicily - whose members were NOT physicians - developed a new and innovative technique for nasal reconstruction using a flap of tissue taken from the upper arm.  This knowledge was apparently transmitted to an Italian surgeon, Gaspare Tagliacozzi (1545-1599), a professor at the University of Bologna, who went on to popularize the procedure as the "Italian method," and to discuss it in detail in his 1597 treatise, De Curlorum Chirurgia per Insitionem, the first text in any language to discuss plastic surgery exclusively.
     What made the Italian method unique was that it involved only partially removing the skin flap from the arm.  One end would remain attached so as to continue the blood flow, and the free end would be shaped into a nose and grafted onto the patient's face.  How?  Like this:

     The arm would be held immobilized in that position for weeks while the graft firmly attached itself, after which the flap would be cut from the arm and the new nose would be molded into shape.  The bottom line, I would say, was that nobody in his or her right mind would undergo this kind of torturous procedure just to remove a bump or two.  The intent was to give noses to the noseless.  In Tagliacozzi's words:

          We restore, rebuild, and make whole those parts which nature hath given, but
          which fortune has taken away. Not so much that it may delight the eye, but that
          it might buoy up the spirit, and help the mind of the afflicted.
     Healing the wounded body and the wounded spirit at the same time.  It sounds like good medicine to me.


  1. Yeouch! The nose knows I guess.

  2. That's quite the illustration. I can't imagining having that done. Even to get a nose back. o.O

    ~Ninja Minion Patricia Lynne aka Patricia Josephine~
    Story Dam
    Patricia Lynne, Indie Author

    1. I'm with you, Patricia. The guy in the illustration is sitting up in bed, which I would imagine is pretty much all you could do while your arm flap was getting grafting onto the middle of your face. Still, for people who had lost their noses and couldn't bear to be seen that way, it must have felt like a godsend nonetheless!

  3. Lost my last attempt to post so will try again. Your article is well-researched and entertaining. Some of the details actually made me cringe, especially about the amputations done as punishment. So inhumane, though less so than beheading.

    Gail’s 2016 April A to Z Challenge
    Theme: The Fun in Writing #217

    1. Thank you, Gail. Yes, inhumanity has abounded throughout human history, I'm afraid. Fortunately, there has always been at least some small measure of kindness too - like Taglicozzi's, for instance.

  4. Wow... undergoing something like that in the middle ages had to be fairly dangerous... Fascinating that people did it none the less :) Especially the Italian method. You had to be rich to sit around like that for weeks without working...

    @TarkabarkaHolgy from
    The Multicolored Diary

    1. I'm guessing you had to be rich to undergo any of these procedures. I think we can be sure that peasants didn't qualify.

  5. Immensely interesting! How could anyone go round for that amount of time with his arm strapped to his head like that?

    Quite familiar with the nose cutting off stuff - Ramayana has an episode where the MC's brother cuts off the nose and ears of a woman who makes unwanted advances to them.

    Catching up with your other posts now.

  6. I would have never imagined that this kind of surgery was already possible in the Middle-ages.
    Really a grat article.

    The Old Shelter - Jazz Age Jazz

    1. Amazing, isn't it? For another post about 16th-century surgery, you can read my last year's A to Z post featuring Ambroise Pare. Now THAT was an amazing man!!

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  8. Oh my! I had no idea nose jobs went back that far...and removing noses? That's going to give me nightmares!

  9. I'm sorry, Stephanie! The sixteenth century wasn't the most genteel time in history, that's for sure. Maybe you should only read my posts first thing in the morning!

  10. Eeek! They actually showed this grafting method on an episode of The Knick... Pretty gruesome for the Middle Ages, but to think only 100 years ago it was still being practiced... Eeek again :D

    Susan, you made my day with the news about the new member in your family! CONGRATULATIONS! So, so happy for you—and for him ;) I look forward to hearing all about it!

    Yay, Dog! Yay, YOU!
    Guilie @ Life In Dogs

    1. Thank you so much, Giulie! Will post a picture right now!!

  11. And punitive amputations; not of noses, but of hands; are still carried out in some countries!

    Many, many congrates on your new family member.

    Keith Channing A-Zing from

  12. What an interesting post. Amputation of noses...yikes!

    I didn't know that rhinoplasties began so long ago. I wonder how a 16th century episode of Nip Tuck would look like.

  13. Oh goodness, utterly fascinating and pretty darn creepy as well. I'm suddenly inspired to give my nose a little bit of love and a promise to protect it.

    1. That sounds like a very wise move, Deborah. As the song says, you don't know what you got til it's gone!