Amputation of the nose throughout history

Mutilation of the most extruding parts of the face (nose, ears, lips) has always meant a very severe impairment, not only of the body, but of the individual’s personality, since it results in a permanent alteration in the most noble and expressive part of the human body. The nose, in particular, was considered, already in very ancient times, the principal element of one’s physiognomy not only as far as concerns the strictly aesthetic aspects (and classic Greek art has offered us countless examples), but also because the form, the aspect itself, appeared to reflect particular qualities of the character, of the psychology of the individual, a topic which, in the past, fascinated many men of great culture, from Michele Savonarola to Gerolamo Cardano, from Giovanni Battista Della Porta to Cesare Lombroso. The importance of the nose, purely as an aesthetic element, as a symbolic value or as an expression of the character of a subject, inspired, over the centuries, not only figurative or plastic art, but also the theatre (Edmond Rostand), poetry (Antonio Guadagnoli) (Fig. ​(Fig.1),1), philosophy (Blaise Pascal), narration (Edmond About, Laurence Sterne, Nicolai Gogol) and even music (Dimitri Shostakovich). Fig. 1 An illustration from Il naso by Antonio Guadagnoli from Arezzo. Poesie giocose di Antonio Guadagnoli, Lugano, 1839. Clearly, patients who, submitted to this type of mutilation, felt deprived of part of their very personality, attempted, in every possible way, to disguise the lesion, and already even in very ancient times, reconstructive surgery or application of a prosthesis were sought after. While, today, severe loss of any part of the nasal arch is fairly rare and is observed only as a result of accidental traumatic events or destructive processes of neoplastic, specific or granulomatous processes, in ancient times, this type of mutilation was much more frequent. Contributing to this increased number were other causes related to certain historic periods and to the particular local customs. Often amputation of the nose was the result of judicial punishment, or may have resulted from a duel or from fighting in a battle, or, in some cases, was inflicted as revenge by a jealous lover, or in others was the consequence of a strange form of self mutilation.