WEBVTT - Rhinoplasty, aka Nose Jobs 0:00:01.440 --> 0:00:04.240 Welcome to Stuff You Should Know, a production of I 0:00:04.360 --> 0:00:13.160 Heart Radio. Hey, and welcome to the podcast. I'm Josh, 0:00:13.200 --> 0:00:17.400 and there's Chuck and there's Jerry, and uh, this is 0:00:17.440 --> 0:00:21.720 Stuff you should Know. The Schnaz edition. It's such a 0:00:21.720 --> 0:00:23.960 great word. It is man and it's such a great 0:00:24.000 --> 0:00:28.200 descriptor to like, I consider my nose a schnaz. There's 0:00:28.240 --> 0:00:31.120 a big difference between schnas and a nose and I've 0:00:31.160 --> 0:00:34.360 got a schnaz. Yeah. And what I think is even funnier. 0:00:35.000 --> 0:00:39.920 And this goes back to the Saturday Night Live, which 0:00:39.920 --> 0:00:44.000 one was it? It was a Martin Short season and 0:00:44.080 --> 0:00:46.800 it was one of the Martin Short sketches where he's 0:00:46.880 --> 0:00:50.680 doing I think Nathan Thurm was the attorney that he 0:00:50.720 --> 0:00:56.320 did occasionally, and he said the word schnas like snaz 0:00:56.960 --> 0:01:01.200 without this and it just made it even funnier. He said, 0:01:01.240 --> 0:01:04.960 we don't make snazzas he's talking about fake noses. So 0:01:05.640 --> 0:01:07.959 did he did he get it wrong or did he 0:01:08.000 --> 0:01:10.520 mess up a line or what was the deal? Oh? 0:01:10.560 --> 0:01:14.120 I think it was just the comedic genius of Martin Short. Yeah, 0:01:14.200 --> 0:01:20.440 he's pretty good. And speaking of which, uh, this has 0:01:20.480 --> 0:01:23.600 nothing to do with that. But we're teasing out listener 0:01:23.640 --> 0:01:27.160 mail today early because we have collected I knew we'd 0:01:27.160 --> 0:01:30.640 get some good grilled cheese tips, and we collected a 0:01:30.680 --> 0:01:33.760 little small compendium. So it's gonna be a bit of 0:01:33.800 --> 0:01:37.319 an extended listener mail where we go over the listener 0:01:37.360 --> 0:01:40.600 mail tips for grilled cheese sandwiches. We're really going to 0:01:40.680 --> 0:01:44.280 wear out that background music. Let's a stick around. So 0:01:44.319 --> 0:01:49.280 we're talking nose jobs today, Chuck also called rhinoplastic. You 0:01:49.280 --> 0:01:52.040 would think rhino plastics the clinical term, and I guess 0:01:52.080 --> 0:01:56.080 technically it is, but if you are a plastic surgeon 0:01:56.200 --> 0:02:00.440 or cosmetic surgeon, um, you would probably not call it 0:02:00.480 --> 0:02:03.639 that any longer. You'd call it nose sculpting instead, which 0:02:04.120 --> 0:02:10.840 to me really kind of underscores the vibe about nose 0:02:11.000 --> 0:02:13.800 jobs today. That is a little bit here, a little 0:02:13.800 --> 0:02:17.239 bit there, nothing too ridiculously radical, and that's a far 0:02:17.360 --> 0:02:20.919 cry from, you know, the rhino plastic of the past, 0:02:20.960 --> 0:02:23.880 from what I understand. Yeah, I've heard it calls no 0:02:24.200 --> 0:02:30.440 nose reshaping as well. And rhino plastic itself comes from Greek, 0:02:30.639 --> 0:02:39.120 of course, rhino meaning nose or SNAs uh and plasticoast 0:02:39.680 --> 0:02:43.000 p l A s I k O s which looks 0:02:43.200 --> 0:02:46.440 so so. Greek means to shape into mold, and that's 0:02:46.440 --> 0:02:50.400 what plastic surgery comes from. Of course, a rhinoplasty is 0:02:51.040 --> 0:02:57.119 just reach re shaping the snaz man. You are on 0:02:57.600 --> 0:03:03.840 fire in man, really, yes, I mean no, it's not no, 0:03:04.040 --> 0:03:06.679 you've been on fire. But I'm saying like, like you've 0:03:06.680 --> 0:03:10.120 really just stepped it up in the last like this 0:03:10.200 --> 0:03:11.760 past year. I don't know what the deal is, but 0:03:11.800 --> 0:03:14.840 I love it. I'm I'm loving it. I'm here for it, 0:03:15.520 --> 0:03:19.600 and I want more and more. All right, nowhere to 0:03:19.600 --> 0:03:22.639 go but down. That's right, that's what they call a 0:03:22.720 --> 0:03:27.120 set up. You're gonna do great, chuck, what kind of snot? 0:03:27.200 --> 0:03:32.000 Thank you for that, by the way, demur, but and 0:03:32.000 --> 0:03:35.480 try to move on very quickly when given a compliment. Yeah, 0:03:35.520 --> 0:03:37.800 well so let's do that here. That's fine, that's fine, 0:03:37.800 --> 0:03:40.160 But I also want to add something to that. I 0:03:40.160 --> 0:03:42.640 I that is now the last time I'm going to 0:03:42.760 --> 0:03:45.960 like drag one of your great jokes out and like, 0:03:46.480 --> 0:03:49.520 you know, beat it with a rug beater until it's 0:03:49.680 --> 0:03:52.800 totally not funny anymore. Now I'm fully on board, So 0:03:52.840 --> 0:03:56.920 I'm just gonna play a lot like it's just normal yeah, Uh, 0:03:57.120 --> 0:03:59.080 what kind of nose job would someone get? Why would 0:03:59.080 --> 0:04:01.720 someone want a nose up? Oh, there's all sorts of 0:04:01.720 --> 0:04:03.640 reasons you could want a nose job. You could be 0:04:03.880 --> 0:04:09.880 a um U seventh century b c. Indian thief or 0:04:09.960 --> 0:04:13.960 adulterer and have had your nose lopped off as punishment. Okay, 0:04:14.040 --> 0:04:17.640 bring it forward. You could have been in uh one 0:04:17.640 --> 0:04:22.600 of the world Wars and been facially um injured by 0:04:22.640 --> 0:04:27.560 a mine. Bring it forward. You could have been born 0:04:28.200 --> 0:04:31.640 with a kind of nose that is characteristic of your 0:04:31.680 --> 0:04:34.640 ethnicity and want to have changed it to fit in 0:04:34.680 --> 0:04:40.720 with waspy mid century America getting closer. And then lastly, 0:04:41.040 --> 0:04:44.760 um you can also want to reshape your nose for 0:04:44.839 --> 0:04:48.960 medical reasons as well. Right, the only thing you left out, 0:04:49.000 --> 0:04:50.440 which and we're going to get to all this stuff 0:04:50.440 --> 0:04:54.320 in greater detail, is you may have had syphilis, which 0:04:54.480 --> 0:04:58.039 let at a time in our history that left you 0:04:58.080 --> 0:05:00.800 with kind of a hole in the front of your face. Us. 0:05:00.920 --> 0:05:05.120 And just big tip for people, do not google syphilis 0:05:05.160 --> 0:05:08.960 nose and look for images because while you will see 0:05:09.000 --> 0:05:12.040 that and that is alarming in and of itself, you 0:05:12.080 --> 0:05:16.039 will see lots of nastiness that you won't be able 0:05:16.040 --> 0:05:20.120 to forget anytime soon. Yeah, because apparently syphilis causes necrosis 0:05:20.200 --> 0:05:23.599 of your soft tissues, and you know, soft tissues combined 0:05:23.640 --> 0:05:26.960 to kind of give us a characteristic appearance, and when 0:05:26.960 --> 0:05:30.640 that soft tissue is missing, it can be you know, um, 0:05:30.680 --> 0:05:33.839 disarming at first or alarming at first until you just 0:05:33.880 --> 0:05:37.000 stop and think, like, what's the person? You know? That's right? 0:05:37.440 --> 0:05:40.640 Uh So as far as cosmetic stuff goes, and if 0:05:40.640 --> 0:05:43.360 this is purely like, hey, I just don't really like 0:05:43.480 --> 0:05:45.200 the way my nose looks and I would like to 0:05:45.920 --> 0:05:48.039 to to get it to look the way I wanted 0:05:48.080 --> 0:05:52.000 to look. Uh. Some of the reasons are just facial balance, 0:05:52.120 --> 0:05:54.400 like how big your face is in relation to the 0:05:54.440 --> 0:05:57.120 size of your nose. You might have trouble with the 0:05:57.160 --> 0:06:00.200 width of your nose. Or it might have something to 0:06:00.240 --> 0:06:04.640 do with a visible hump or bump, which I love. 0:06:05.560 --> 0:06:09.240 Uh yeah, I think is it called a Roman nose? Yes, 0:06:10.480 --> 0:06:14.400 that has sort of the hump. Yeah. You find it 0:06:14.440 --> 0:06:18.239 to be a very attractive feature on a lady. Gotcha? Okay? Cool, 0:06:20.360 --> 0:06:23.600 So I'm I'm a fan. Um, so you know that 0:06:23.640 --> 0:06:26.120 would be something you would see more in profile, or 0:06:26.160 --> 0:06:27.840 you know, it might be the tip of your nose 0:06:27.920 --> 0:06:30.760 might droop or be turned up in a more I 0:06:30.760 --> 0:06:32.960 guess they call it technically they call it a pug 0:06:33.000 --> 0:06:36.600 fashion um or it might be hooked, or you might 0:06:36.600 --> 0:06:39.680 not like your nostrils they may not be symmetrical like 0:06:40.000 --> 0:06:43.479 they can kind of do whatever you want done these days. Yeah, 0:06:43.560 --> 0:06:46.920 that's definitely true. And one of the things that um 0:06:46.960 --> 0:06:49.160 that has evolved as far as nose jobs goes, that 0:06:49.200 --> 0:06:52.400 I kind of touched on earlier is it's no it 0:06:52.640 --> 0:06:55.159 used to be, especially in the heyday of the mid century, 0:06:55.200 --> 0:06:58.120 of the fifties and sixties, when you know, nose jobs 0:06:58.160 --> 0:07:01.080 really sorry to take off for cosmetic reasons, especially among 0:07:01.560 --> 0:07:05.880 um people of Jewish ancestry in America. There was like 0:07:06.120 --> 0:07:09.200 I want this nose. You go in with a magazine picture, 0:07:09.680 --> 0:07:11.760 or you go in with your friend and be like, 0:07:11.800 --> 0:07:14.040 give me her nose. You did her nose, I want 0:07:14.080 --> 0:07:17.120 the same nose, And like there was a just this 0:07:17.240 --> 0:07:20.360 kind of general idea that you you just got exactly 0:07:20.400 --> 0:07:23.080 the nose you wanted without any regard to whether that 0:07:23.200 --> 0:07:27.760 nose actually look natural on your face. And it's evolved 0:07:27.800 --> 0:07:29.800 over time. And one of the reasons why it was 0:07:29.840 --> 0:07:32.680 because there was like a perfect nose in American nose, 0:07:32.720 --> 0:07:36.320 a Caucasian knows that was like an ideal version of beauty. 0:07:36.880 --> 0:07:41.040 And over time, especially in the last like Tanner so years, 0:07:41.080 --> 0:07:45.040 it seems like there's been a huge sea change in 0:07:45.440 --> 0:07:47.800 the way people who get those jobs approach it, and 0:07:47.840 --> 0:07:51.640 that they're like, can you just take the more extreme 0:07:51.720 --> 0:07:53.800 features of my nose, like you just went over on 0:07:53.880 --> 0:07:56.040 that list and just kind of tone them down a 0:07:56.040 --> 0:07:58.200 little bit. Don't give me a different nose. I want 0:07:58.400 --> 0:08:02.480 a slightly more idealized version of my nose. I want 0:08:02.480 --> 0:08:04.800 to look like myself. I don't want somebody else's nose. 0:08:04.840 --> 0:08:07.360 I just want it tamed a little bit. And that's 0:08:07.480 --> 0:08:09.600 kind of where it stands today from everything I saw 0:08:09.640 --> 0:08:12.800 as far as nose jobs go. Yeah, and it sort 0:08:12.800 --> 0:08:15.280 of reminds me of that great scene from the movie 0:08:15.320 --> 0:08:19.720 Singles when Bridget Fonda goes in for breast augmentation surgery 0:08:20.600 --> 0:08:27.920 and Bill Pullman is the surgeon. Yeah, Bill Pullman, and 0:08:27.920 --> 0:08:29.840 I wasn't thinking Bill Paxton, and I just couldn't remember 0:08:29.880 --> 0:08:32.760 if it was Bill Pullman. Uh, and she You know, 0:08:32.840 --> 0:08:35.559 they have the little weird science program where they make 0:08:35.600 --> 0:08:37.480 the breast larger or smaller by just hitting up or 0:08:37.520 --> 0:08:39.960 down on the computer, and she goes way big, and 0:08:40.000 --> 0:08:43.679 he's like, why don't we like fit your frame a 0:08:43.679 --> 0:08:46.400 little more. He's sort of trying to talk her into 0:08:46.480 --> 0:08:50.160 just a more reasonable form of that surgery. And I think, 0:08:50.480 --> 0:08:51.800 and that was a long time ago, and I think 0:08:51.800 --> 0:08:54.640 you're right. I think these days, and of course people 0:08:54.720 --> 0:08:57.640 get all kinds of extreme, you know, body surgery done, 0:08:57.679 --> 0:08:59.800 but I think these days it is a little bit 0:08:59.840 --> 0:09:03.480 more or common for someone to say like, hey, I'm 0:09:03.480 --> 0:09:05.640 not trying to look like a completely different version, but 0:09:05.840 --> 0:09:08.120 this one thing is always bothered me. Yeah, and then 0:09:08.240 --> 0:09:10.280 one other thing I want to say too, that seems 0:09:10.320 --> 0:09:14.640 to be a common um part of the discussion around 0:09:14.640 --> 0:09:18.160 nose jobs is um. A lot of people who get 0:09:18.200 --> 0:09:20.800 them tend to view them as not so much like 0:09:21.400 --> 0:09:25.319 a physical um operation, or it is a physical operation, 0:09:25.360 --> 0:09:29.480 but it's to correct a psychological issue that the person 0:09:29.679 --> 0:09:34.080 doesn't actually like. There's nothing wrong with their nose, they 0:09:34.120 --> 0:09:36.559 just don't like their nose, and they've come to dislike 0:09:36.559 --> 0:09:39.800 their nose so much that they have trouble like living 0:09:39.840 --> 0:09:42.240 their life because they're so self conscious about it. And 0:09:42.280 --> 0:09:45.720 to them, people who get nose jobs say this is 0:09:45.840 --> 0:09:48.320 this is this, this is just smart, Like, there's no 0:09:48.400 --> 0:09:50.520 reason for me not to do this. It's going to help, 0:09:50.760 --> 0:09:54.959 and apparently it does help sometimes. So I don't encourage 0:09:54.960 --> 0:09:57.520 it one way or the other. I certainly don't um 0:09:57.720 --> 0:10:00.719 judge or criticize or anybody who does get a nose 0:10:00.800 --> 0:10:02.559 job if they feel like it's the right thing for them. 0:10:02.600 --> 0:10:05.199 But it just seems chuck very much in step with 0:10:05.520 --> 0:10:08.600 the century and the like people in there, you know, 0:10:08.720 --> 0:10:11.720 late teens and twenties and you know, even early thirties 0:10:11.720 --> 0:10:14.640 are just so aware, way more aware than we were 0:10:14.679 --> 0:10:18.120 when we were their age. Um that that kind of 0:10:18.280 --> 0:10:20.800 has to do with nose jobs. Who has trans translated 0:10:20.800 --> 0:10:22.720 and transferred over to nose jobs that people are just 0:10:23.240 --> 0:10:25.760 thinking more about it rather than I hate my nose, 0:10:25.840 --> 0:10:28.640 I want this nose, you know. Yeah, I think it 0:10:28.640 --> 0:10:32.320 falls into the general umbrella of like, now there's a 0:10:32.320 --> 0:10:36.400 lot more um sort of shunning of this idealized beauty 0:10:36.600 --> 0:10:39.640 notion then there has been in a long time. And 0:10:40.200 --> 0:10:41.920 I'm not weighing in one or the other either because 0:10:41.920 --> 0:10:44.200 it's a very personal choice. But I will say that 0:10:44.240 --> 0:10:47.360 I do love the idea of this idealized form of 0:10:47.400 --> 0:10:50.880 beauty being kind of kick to the curb to say 0:10:50.920 --> 0:10:53.240 something more modern. Deed, there are a few things that 0:10:53.280 --> 0:10:55.959 have been more harmful that didn't involve like guns or 0:10:56.080 --> 0:11:01.800 explosions than and a single idealized form of beauty, you know, alright, 0:11:01.840 --> 0:11:05.120 so I agree. Um, let's go over some statistics right 0:11:05.120 --> 0:11:07.400 out of the gate. Most of these are from the 0:11:07.480 --> 0:11:10.880 United States. We do have a few international statistics, but 0:11:10.920 --> 0:11:13.880 it seems like those are a little harder to trust 0:11:14.320 --> 0:11:17.480 just based on how they're gathered. But about two point 0:11:17.559 --> 0:11:23.080 three million, um, I think this is complete cosmetic surgical 0:11:23.120 --> 0:11:29.319 procedures in the US, and I think it knows reshaping 0:11:29.520 --> 0:11:32.480 is and was the most common. About three D fifty 0:11:32.520 --> 0:11:37.439 two tho nose jobs in the US far more women 0:11:37.720 --> 0:11:40.520 two eight seven thousand compared to sixty five thousand men 0:11:41.280 --> 0:11:46.880 and teens make up about of those. Nine year olds 0:11:46.880 --> 0:11:50.160 make up thirty one. If you live out West, you're 0:11:50.200 --> 0:11:52.680 more likely about a third of the nose jobs are 0:11:52.720 --> 0:11:55.200 performed dot West. I don't know if that means, you know, 0:11:55.360 --> 0:12:00.319 Los Angeles County and probably uh and then called Aasian 0:12:00.320 --> 0:12:03.040 White people get way more nose jobs than anyone else 0:12:03.080 --> 0:12:05.880 by a long shot. Seventy one of the nose jobs 0:12:05.880 --> 0:12:11.840 in twenty were on Caucasians African Americans with just five percent, Hispanic, 0:12:11.920 --> 0:12:16.079 ten percent, in Asian Pacific Islander eleven percent. So if 0:12:16.120 --> 0:12:21.600 you're a white American twenty five year old woman living 0:12:21.600 --> 0:12:24.120 in Los Angeles, there's basically a hundred percent chance that 0:12:24.160 --> 0:12:25.960 you're going to get a nose job. I think you 0:12:26.040 --> 0:12:29.920 have to from what I'm seeing here. Um, what about internationally, Well, 0:12:29.960 --> 0:12:33.240 like you said, the stats are a little wobbly compared 0:12:33.280 --> 0:12:37.120 to the U. S A stats, But apparently Brazil is 0:12:37.240 --> 0:12:43.360 number one, they're the leader, um, followed by Turkey and America. Um, 0:12:43.400 --> 0:12:48.200 and then Argentina and Russia. This list, I've seen reference 0:12:48.240 --> 0:12:52.720 elsewhere that Iran is actually number four behind Brazil, Mexico, 0:12:53.000 --> 0:12:56.080 and America. So it's just it's just up for grabs. 0:12:56.120 --> 0:13:00.599 Apparently the rhino plastic reporting standards around the world or 0:13:00.679 --> 0:13:05.480 have have something to be desired. Sure, but let's just 0:13:05.520 --> 0:13:08.920 say in the top five, six seven, you could definitely 0:13:09.120 --> 0:13:14.000 have Brazil, the United States, Mexico, Iran, Turkey, that kind 0:13:14.040 --> 0:13:17.320 of thing, right. I think that's because the way they 0:13:17.360 --> 0:13:19.960 count rhino plasty around the world is they just have 0:13:20.000 --> 0:13:22.559 a little like a suggestion box type thing on the 0:13:22.600 --> 0:13:24.360 way out, and they say, well, you like to keep 0:13:24.400 --> 0:13:26.000 track it? Who does this? To just write your real 0:13:26.160 --> 0:13:28.240 name on a piece of paper and just stick it 0:13:28.240 --> 0:13:30.720 in there, or we'll just trust you to do that. 0:13:30.760 --> 0:13:34.760 There is a big mistranslation and they accidentally translated translated 0:13:35.080 --> 0:13:42.640 not Schnas but SNAs confused everybody else. That's good. Uh, 0:13:42.800 --> 0:13:44.800 should we take a break here and then dive into 0:13:44.800 --> 0:14:11.319 the history. All right, let's do it. So, Chuck, I 0:14:11.400 --> 0:14:16.400 made reference before about living in six hundred or the 0:14:16.440 --> 0:14:22.280 seventh century BC. Um, and maybe you were undergoing a 0:14:22.400 --> 0:14:26.000 rhino plastic operation because you had your nose removed as 0:14:26.120 --> 0:14:32.000 a punishment. Um. That's actually where rhino plastic began. Like, 0:14:32.360 --> 0:14:35.640 it's not like there was some ridiculously primitive procedure that 0:14:35.680 --> 0:14:38.120 somebody tried once and then the idea was lost for 0:14:38.480 --> 0:14:41.320 a couple of thousand years, and then it got developed 0:14:41.320 --> 0:14:43.840 in the nineteenth century by some British guy. That's not 0:14:43.880 --> 0:14:46.680 at all how it happened. There was an Indian surgeon 0:14:46.800 --> 0:14:49.400 named sush Rida, which is not his name is actually 0:14:49.440 --> 0:14:53.280 an adjective that means renowned. But Sushrita is considered the 0:14:53.360 --> 0:14:56.960 father of cosmetic surgery, and that this guy was not 0:14:57.080 --> 0:15:03.080 only performing cosmetic surgery like rebuilding noses from nothing, um, 0:15:03.120 --> 0:15:06.280 he was documenting it too, in in medical texts that 0:15:06.360 --> 0:15:09.200 he wrote that survived, and he created a technique called 0:15:09.240 --> 0:15:11.800 the Indian flap that was still in use into the 0:15:11.800 --> 0:15:16.400 twentieth century. Is that how it's pronounced his name, Sushrida. 0:15:17.000 --> 0:15:20.360 Mm hmm, that's what I'm going sus Shrewda. I mean 0:15:20.360 --> 0:15:23.160 that's you. I guess I'm in the mood for a margarita. 0:15:25.840 --> 0:15:27.480 I'm in the mood to do a little dance called 0:15:27.480 --> 0:15:29.480 the Indian flap because that sounds like a lot of 0:15:29.480 --> 0:15:33.320 fun at a party. Um, the surgical procedure not so fun. 0:15:35.320 --> 0:15:37.120 I mean, should we read part of this? Yes? Or 0:15:37.120 --> 0:15:40.160 should we read all of it? I think it's it's worthwhile. Yeah, alright. 0:15:40.200 --> 0:15:43.600 So this was a description of the Indian flap technique 0:15:43.640 --> 0:15:49.760 from Sa Shrewda aka Sashrida himself. The portion of the 0:15:49.760 --> 0:15:51.560 nose to be covered should be first measured with a 0:15:51.640 --> 0:15:54.600 leaf as you do. Uh. Then a piece of skin 0:15:54.640 --> 0:15:57.520 of the required size should be dissected from the living 0:15:57.560 --> 0:16:00.280 skin of the cheek, which is super advanced. Still what 0:16:00.320 --> 0:16:03.160 I mean scrafting right right, and it's leaving bud supply 0:16:03.280 --> 0:16:05.960 coming from the cheek. Still yeah, very smart, very good. 0:16:06.560 --> 0:16:10.440 Uh So we're we're approving of these surgical methods, year 0:16:10.480 --> 0:16:13.720 old surgical methods. You know, we're we're in a position 0:16:13.720 --> 0:16:17.880 to do that. We live in the twenty one century, baby, yeah, exactly. Uh. 0:16:18.000 --> 0:16:20.680 Let me see, uh dissected from the looming skin in 0:16:20.680 --> 0:16:23.600 the cheek and turned back to cover the nose, keeping 0:16:23.600 --> 0:16:28.560 a small uh pedical attached to the cheek, which is 0:16:28.600 --> 0:16:32.720 what you referenced. The physician should then place the skin 0:16:32.920 --> 0:16:36.320 on the nose and stitch the two parts swiftly, keeping 0:16:36.360 --> 0:16:39.960 the skin properly elevated by inserting two tubes of ronda, 0:16:40.200 --> 0:16:42.600 which is a castor oil plant, and the position of 0:16:42.600 --> 0:16:45.280 the nostrils so that the new nose gets proper shape 0:16:45.520 --> 0:16:48.360 when the skin has united and granulated. If the nose 0:16:48.440 --> 0:16:50.400 is too short or too long, the middle of the 0:16:50.400 --> 0:16:53.120 flap should be divided and an endeavor made to enlarge 0:16:53.160 --> 0:16:56.680 or shorten it so it sounds like they're just taking 0:16:56.680 --> 0:16:59.840 part of the cheek, folding it back over into itself 0:16:59.840 --> 0:17:02.520 to meet the other part with a tube in the 0:17:02.560 --> 0:17:05.720 middle and then having it grow together, right, yeah, two 0:17:05.760 --> 0:17:08.119 tubes tubes. Yeah, and they still do that today. They 0:17:08.200 --> 0:17:12.600 use um stents to hold to to have the the 0:17:12.760 --> 0:17:16.600 procedure hold its place or shape afterward, um, and they 0:17:16.680 --> 0:17:19.240 leave it in there to until it heals. So like 0:17:19.320 --> 0:17:22.360 this guy was basically it's like that saying, I can't 0:17:22.359 --> 0:17:25.680 remember where it came up, but um, somebody was describing 0:17:25.720 --> 0:17:29.600 how advanced this development was or whatever development it was 0:17:29.920 --> 0:17:32.320 right out of the gate where they said that they 0:17:32.400 --> 0:17:38.680 basically invented the airplane fully functioning with like trade tables 0:17:38.720 --> 0:17:42.000 for in flight meals and everything. Like totally, this guy 0:17:42.040 --> 0:17:45.000 like just figured it out from the outs. And it's 0:17:45.000 --> 0:17:48.439 not like we're taking you know, the skin from your 0:17:48.520 --> 0:17:53.000 cheek today and using that um to to um to 0:17:53.040 --> 0:17:55.600 build a brand new nose that would probably actually be 0:17:55.640 --> 0:17:57.680 more likely to take it from other parts of your body. 0:17:57.960 --> 0:18:01.719 But the concept are still very much the same. And 0:18:02.119 --> 0:18:04.520 it's weird to think that rhino plastic has been around 0:18:05.240 --> 0:18:09.400 kind of unchanged for almost three thousand years. Yeah, And 0:18:09.480 --> 0:18:12.080 just to reiterate, so it's clear, this is the procedure 0:18:12.080 --> 0:18:14.520 when there was no more nose because it had been 0:18:14.560 --> 0:18:17.600 completely cut off so they're really starting from zero and 0:18:17.680 --> 0:18:20.879 forming a new nose. Uh. And yeah, it's pretty amazing. 0:18:21.040 --> 0:18:24.480 And I'm sure compared to what I mean, no matter 0:18:24.520 --> 0:18:26.880 the result, it probably looked better than what they had 0:18:26.880 --> 0:18:29.720 going on before, would be my guess. Yeah. Um, so 0:18:31.200 --> 0:18:36.160 this uh, this, this technique made its way um through 0:18:36.440 --> 0:18:40.160 uh Egypt or out from India and to Egypt over 0:18:40.200 --> 0:18:43.800 to Europe. Finally, um, where they were dealing with syphilis 0:18:43.840 --> 0:18:48.240 outbreaks in the fifteen and sixteenth century, like you were mentioning, Um, 0:18:48.280 --> 0:18:52.240 there's an Italian surgeon that made his contribution guests, bar actually, 0:18:52.320 --> 0:18:56.680 I think you should take this Gaspari Techlia Colzy very 0:18:56.760 --> 0:19:01.320 nice and back. He said, I'm really going to advance this. 0:19:01.680 --> 0:19:04.320 Instead of that skin from your cheek, I'm going to 0:19:04.400 --> 0:19:06.360 take it from your upper arm. So he just kind 0:19:06.359 --> 0:19:09.040 of did a modified Indian flap, and I guess you'd 0:19:09.040 --> 0:19:12.480 call that the Italian flap. But then finally in the 0:19:12.560 --> 0:19:16.560 nineteenth century, Um, there were a couple of surgeons in 0:19:16.600 --> 0:19:19.159 the late nineteenth century who really kind of duke it 0:19:19.240 --> 0:19:24.080 out for the title of father of plastic surgery, or 0:19:24.160 --> 0:19:27.400 at least aesthetic plastic surgery, because we got really good 0:19:27.440 --> 0:19:32.320 at doing things like rebuilding noses using rhino plastic, and 0:19:32.359 --> 0:19:34.879 we got so good at that people started saying like, hey, 0:19:35.240 --> 0:19:37.720 your nose is perfectly fine and it functions, but would 0:19:37.760 --> 0:19:39.680 you like to take a little off the top, And 0:19:40.040 --> 0:19:44.520 cosmetic surgery was born. That's right. I believe the first 0:19:44.520 --> 0:19:48.080 gentleman you're referring to is a michigan Er. Is that 0:19:48.119 --> 0:19:52.240 what they call themselves? I think it's actually Gander. I'm 0:19:52.280 --> 0:19:56.760 not kidding, yes, because I saw an interview with UM. 0:19:57.200 --> 0:20:00.320 I can't remember their governor's name, but she had a 0:20:00.359 --> 0:20:03.639 sign that said like proud Michigander. Yeah, yeah, I know 0:20:03.720 --> 0:20:08.720 the governor, Okay, Michigander. I like that. Seven. His name 0:20:08.760 --> 0:20:11.880 was John Orlando or Rowe. And this was I think 0:20:11.920 --> 0:20:17.400 technically the first paper about cosmetic nose jobs, called Correction 0:20:17.480 --> 0:20:21.240 of the Pug Deformity. And then the next guy, he 0:20:21.320 --> 0:20:25.560 had some fun nicknames. He was a Jewish German surgeon 0:20:25.680 --> 0:20:32.360 named Dr Jacques Joseph uh and his nickname was nos Joseph. 0:20:33.720 --> 0:20:37.520 Pretty good. Yeah. He actually UM kind of ties into 0:20:37.600 --> 0:20:41.840 our episode on World War One soldier masks. Do you 0:20:41.840 --> 0:20:44.360 remember that? Yeah? Yeah, I knew this wrong A bell 0:20:44.520 --> 0:20:47.399 I get the impression that he was probably working in 0:20:47.440 --> 0:20:51.320 the same maybe the same campus that the guy who 0:20:51.440 --> 0:20:54.760 led that mask department to to build masks for UM 0:20:55.040 --> 0:20:58.960 soldiers who came back with UM facial differences from from 0:20:58.960 --> 0:21:01.840 like bombs and bullets and stuff. Uh, this guy was 0:21:01.880 --> 0:21:08.000 actually doing cosmetic surgery UM to help prepare those injuries. UM. 0:21:08.080 --> 0:21:14.800 And he got interested eventually in making UM changes to 0:21:14.920 --> 0:21:19.720 help uh Jewish Europeans fit in better. And we'll talk 0:21:19.760 --> 0:21:21.720 a little more about that later when we talk about 0:21:21.920 --> 0:21:25.880 ethnic cosmetic surgery. But UM, that was kind of like 0:21:26.359 --> 0:21:28.760 his evolution. He went from helping soldiers to kind of 0:21:28.760 --> 0:21:32.639 helping you know, wealthy citizen re in Europe. Uh. And 0:21:32.720 --> 0:21:34.960 because of that, because this guy showed that there was 0:21:35.000 --> 0:21:38.440 a huge demand that no one realized was actually there 0:21:38.480 --> 0:21:43.800 before a huge explosion of I don't know, Charlatan's ne'er 0:21:43.840 --> 0:21:50.080 do wells, shiftless slackers, snake oil salesman. I'm sure um 0:21:50.160 --> 0:21:53.439 who who figured out like, hey, I'll just give this 0:21:53.520 --> 0:21:56.119 a shot. How hard can it be? Um? And the 0:21:56.600 --> 0:22:01.480 rise of the beauty doctor came along. Yeah, the beauty doctor. Uh, 0:22:01.520 --> 0:22:04.120 it's sort of a contradictory name, I would imagine because 0:22:04.600 --> 0:22:10.959 these were the unlicensed practitioners out patient knows jobs like hey, 0:22:11.000 --> 0:22:13.680 I've got some paraffin wax, let me inject that in there, 0:22:14.400 --> 0:22:16.480 because that's a great idea. Just don't go out in 0:22:16.520 --> 0:22:20.960 the sun. And it's also carcinogenic. So this was you know, 0:22:21.080 --> 0:22:24.280 a very sort of um cut rate job that you 0:22:24.280 --> 0:22:26.719 didn't have to pay a lot of money for and 0:22:27.240 --> 0:22:30.320 it's probably the you know, the expectation was not great, 0:22:30.400 --> 0:22:33.879 but it was at a time where I guess, you know, 0:22:34.760 --> 0:22:38.880 legitimate plastic surgery was just entering the fray, so people 0:22:38.920 --> 0:22:41.000 didn't know any better, and so there were a lot 0:22:41.000 --> 0:22:44.080 of bad, bad outcomes. I think from these beauty doctors. 0:22:44.200 --> 0:22:46.400 What what's nuts to me, Chuck? Is this still going 0:22:46.440 --> 0:22:50.520 on today with button augmentation. There's a lot of underground 0:22:51.280 --> 0:22:56.600 like unlicensed people who use non medical stuff like silicone 0:22:57.240 --> 0:23:00.840 and pump it into people's bots to like make your 0:23:00.840 --> 0:23:04.879 butt bigger. Um, And it's cheaper. Like you said, it's 0:23:04.960 --> 0:23:07.679 much cheaper because their unlicensed and they kind of know 0:23:07.720 --> 0:23:10.800 what they're doing from experience. But they also have no 0:23:11.000 --> 0:23:13.200 way of getting you to the hospital. They're not doing 0:23:13.240 --> 0:23:15.280 this in the hospital, and some people have died. I 0:23:15.280 --> 0:23:17.960 wrote about a mother daughter team who killed a woman 0:23:18.000 --> 0:23:21.400 because they injected silicon and they accidentally got it into 0:23:21.440 --> 0:23:24.400 her muscle, which introduced to the bloodstream and killed her 0:23:24.440 --> 0:23:27.320 within an hour or so. Um, it is really sad. 0:23:27.840 --> 0:23:30.159 Um And apparently there's been other people who died like this, 0:23:30.200 --> 0:23:33.160 so it's still going on. But as far as rhinoplasty 0:23:33.240 --> 0:23:37.199 is concerned, I'm pretty sure it's widespread enough and just 0:23:37.359 --> 0:23:40.399 affordable enough that people aren't going to underground surgeons like 0:23:40.440 --> 0:23:43.119 they were in the nineteenth century for it. Yeah. I 0:23:43.160 --> 0:23:45.160 mean it's sad that that still exists and that people 0:23:45.200 --> 0:23:46.720 can get away with doing this stuff like out of 0:23:46.720 --> 0:23:50.879 their houses, you know. Um, So things boomed in the 0:23:50.960 --> 0:23:53.760 nineteen fifties in the US, like you were talking, and 0:23:53.840 --> 0:23:55.480 I guess now comes the time where we talk a 0:23:55.520 --> 0:24:01.080 little bit about the procedure itself and the nose itself. Um, 0:24:01.119 --> 0:24:03.199 it's a little you know. What really helps is if 0:24:03.240 --> 0:24:06.000 you're not driving a car or something, if you can 0:24:06.119 --> 0:24:08.760 just look up sort of a a profile of the 0:24:08.800 --> 0:24:13.240