Who, these days, hasn’t heard of someone having a little nip/tuck, a quick injection to get rid of impending wrinkles?

Plastic surgery has become normalised in our day-to-day lives. So, having followed the recent reports on the over-availability and casual abuse of cosmetic procedures, I thought it apt to ponder on the roots of such vanities.

Most prominent in our collections is the replacement and reconstruction of that exposed facial appendage, the nose. Contrary to the majority of ‘nose jobs’ in contemporary society, which are often a result of whim (‘it’s too large/a bit beaky’), and the public intrigue these procedures conjure (makeover programmes offering a new nose alongside a new wardrobe treat it as just another accessory), nose jobs back in the day were actions of necessity. They often replaced the missing feature, involving an arduous procedure (given, there was an element of vanity involved).

Our earliest patient is the infamous Tycho Brahe (1546-1601). Known for his extensive contributions to astronomy, he is also known for his volatile nature, which got him into a spot of trouble in Wittenberg in 1566, resulting in a duel that saw him part with most of his nose. Tycho’s solution was to wear a brass facsimile (it is thought he wore a gold or silver one for special occasions …).


The ‘Italian method’ of nasal reconstruction, from Carpue, J C ‘An account of two successful operations for restoring a lost nose’ (London, 1816), plate 2


New surgical approaches inevitably developed. In J C Carpue’s 1816 publication An Account of Two Successful Operations for Restoring a Lost Nose …, he first discusses the ‘Italian method’, illustrated above. This process grafted a section of skin from the upper arm to the damaged nose, requiring the patient to wear a rather cumbersome suit to hold everything in place for around three weeks, until the skin took. Unfortunately this technique often failed to endure; these new noses were said to be rather vulnerable to particularly cold winters, often turning purple or dropping off.

The method Carpue recommends instead is the ‘Indian Method’, which was considered more reliable. The origins of the treatment are rather macabre: the removal of the nose was a known punishment and torture in India, so replacement noses were in demand. The ‘Indian Method’ involved taking a nose-sized section of skin from the forehead of the patient, keeping the skin attached at the bridge of the nose for blood supply. The flap was then twisted into place, covering the damaged area, and sewn on. The wound on the forehead was stitched up and was said to cause little scarring.


Lieutenant Matthew Latham, from Carpue, J C ‘An account of two successful operations for restoring a lost nose’ (London, 1816), plate 4


The patient we see above is the heroic (and rather dashing) Lieutenant Matthew Latham, who lost his nose at the Battle of Albuera (1811) while protecting the King’s flag from the attacking French hussars. Crying “I will surrender it only with my life”, Latham ultimately kept his life but lost his nose. In recognition of his heroics, the Prince Regent offered to pay for treatment by Carpue, who was said to be performing “miraculous” surgery upon the “most frightful mutilations of the face”.

The portrait of Latham, and that of Carpue’s second (syphilitic) patient, shown below, tell us the value placed on one’s facial appearance. Despite the medical and academic nature of the image, the patients are depicted in Gainsborough-esque style, with dreamy eyes and neatly curling locks.


An unnamed sufferer from syphilis, from Carpue, J C ‘An account of two successful operations for restoring a lost nose’ (London, 1816), plate 1


How many people who have opted for contemporary nose jobs would have made the same decision knowing they had to go through, say, the  lengthy ‘Italian Method’? This illustrates how far-flung our concept of ‘necessity’ is from that of 300 or so years ago, highlighting how far we have advanced, but also how far we have trivialised such procedures.

Rebecca Easey is a Masters student at the University of Sussex. She is currently on a placement at the Royal Society assisting with the digitisation of images for the Picture


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