Plastic and cosmetic surgery

by Frederick Strange Kolle

For centuries following, and throughout the middle ages, the art seems to have waned and remained practically unknown, as far as is shown in the literature of that period.

A revivalist first appeared about the middle of the fifteenth century in the person of Branca, of Catania, a Sicilian surgeon, who about 1442 established a reputation of building up noses from the skin of the face (exore). His son Antonius enlarged upon his methods and is said to have utilized the integument of the arm to accomplish the same result, thus overcoming the extensive scarring of the face following the elder’s mode. He seems to have been the first authority employing the so-called Italian rhinoplastic method. He is also known to have ventured, more or less, successfully in operations about the lips and ears.

Balthazar Pavoni and Mongitore repeated these methods of operative procedure with more or less success and the brothers Bojanis acquired great celebrity at Naples in the art of remodeling noses.

Vincent Vianeo followed the work of the above.

But, somehow, the heroic efforts of these men dropped so much into oblivion that Fabricius ab Aquapende, in writing of the rhinoplastic work of the brothers Bojani, of Calabria, says: “Primi qui modum reparandi nasum coluere, fuerunt calabri; deinde devenit ad medicos Bononienses.”

That Germany was interested at an early date is shown in the admirable work of a chevalier of the Teutonic Order, Brother Heinrich Von Pfohlspundt, who wrote a book on the subject entitled “Buch der Brundth Ertznei,” with a subtitle, “Eynem eine nawe nasse zu mache.” His volume appeared in 1460, about the time of Antonio Branca, of whose methods he was ignorant, claiming to have learned the art from an Italian who succored many by his skill.

Between the years of 1546 and 1599 Kaspar Tagliacozzi, Professor at Bologna, followed the art of rhinoplasty. His pupils published a book at Venice, describing his work in 1597, entitled “De Corturum chirurgia per insitionem,” which established the first authentic volume in restorative surgery. His operation for restoring the entire nose from a double pedicle flap taken from the arm was declared famous and the operation he then advocated still bears his name.

The great Ambroise Pare knew little of rhinoplasty except what he learned from hearsay. As an instance, he relates in 1575 that “A gentleman named Cadet de Saint-Thoan, who had lost his nose, for a long time wore a nose made of silver and while being much hurt by the criticisms and taunts of his acquaintances heard of a master in Italy who restored noses. He went there and had his facial organ restored, and returned to the great surprise of his friends, who marveled at the change in their formerly silver-nosed friend.”

Now again came a century of forgetfulness, the scientific world taking no cognizance of the work done until, suddenly, in 1794, a message came from Poonah, India, to the effect that an East Indian peasant named Cowasjee, a cowherd following the English army, was captured by Tippo Sahib, who ordered the prisoner’s nose to be amputated. His wounds were dressed and healed by English surgeons. Shortly after this the victim of this odd mode of punishment was befriended by the Koomas, a colony of potters, or, as others claim, a religious sect, who knew how to restore the nose by means of a flap taken from the forehead. They operated on him and restored his nose much to the surprise of Pennant, who reported the case in England.