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Words Monica Uszerowicz
Photography Anna Pogossova

On rhinoplasty, eugenics and the strange mythos of the nose

Monica Uszerowicz is a writer and photographer based in Miami, Florida.

Writer Monica Uszerowicz wrestles—and makes peace with—her nose.

Though treatments for a broken nose are outlined in the Edwin Smith Papyrus—an ancient Egyptian medical text—the documented history of rhinoplasty might begin around 500 BCE, when Susruta, an Indian physician, authored The Compendium of Susruta. He spends time outlining the forehead flap rhinoplasty, a grafting procedure likely performed in India long before its documentation, which sees skin above the eyebrows pivoted vertically. In a 2013 edition of Seminars in Plastic Surgery, the forehead flap is referred to as “the gold standard of nasal soft tissue reconstruction.” Especially necessary in Susruta’s day, when the removal of the nose was standard punishment for crimes like theft, the forehead flap is still de rigueur for noses in need of major reconstruction.

Later rhinoplasty treatments were still primarily cures for deformities and injuries. Written and published in 1597 by Gaspare Tagliacozzi, a professor of anatomy and surgery at the University of Bologna, De Curtorum Chirurgia Per Insitionem—or The Surgery of Defects by Implantations—features a diagram of a patient who underwent intricate grafting surgery, transferring skin from his upper arm to his nose. The two body parts remained attached via a strange cage of a contraption, requiring the patient to keep his hand firmly on his head for weeks at a time.

The father of cosmetic rhinoplasty is commonly assumed to be Jacques Joseph, born Jakob Joseph in Konigsberg, Prussia. The son of Rabbi Israel Joseph, the younger Joseph became a general practitioner after receiving his doctorate in Leipzig. In 1892, he was accepted for training at the Berlin University Clinic for orthopaedic surgery. While under the tutelage of Professor Julius Wolff, Joseph performed an otoplasty, pinning back the unruly ears of a young boy who’d been mocked for the way they stuck out. Though the surgery was a success, otoplasty, a relatively new, unregulated procedure, was considered a risky move on Joseph’s part. He lost his job.

When Joseph returned to his private practice, a patient requested the doctor’s assistance in reducing the size of his nose. This time, Joseph was more careful, practicing on cadavers before carrying out the requested rhinoplasty on a living, breathing human. It went well, and in 1898, he reported its success to the Berlin Medical Society, accompanying his declaration with a special theory: the psychological effects of aesthetic surgery, he explained, carried their own significance. If a person’s appearance caused enough prejudice to result in economic disadvantage or social distress, they could be understood as experiencing a kind of suffering. In pre-World War II Germany, such an idea was not only compassionate, but practical. As his practice expanded, Joseph was reported to have operated on individuals “suffering from a Jewish nose” free of charge.

In January of 2014, American news outlets began profiling a 15-year-old girl named Renata—surname deliberately withheld—who’d received funding for a nose job. She’d been homeschooled the past three years, humiliated by peers taunting her appearance. It’s arguable her face had not quite finished developing; to be fond of it at 15 is rare and may, in fact, create a different kind of social exclusion. But Renata was distraught, and reached out to the Little Baby Face Foundation, a New York non-profit that treats children born with physical defects for free. This was not the first time Dr Thomas Romo III, the foundation’s director, had agreed to such an endeavour, likening the process to deformity correction and self- empowerment for patients. Two years prior, he’d performed an otoplasty and rhinoplasty for 14-year-old Nadia Ilse, also bullied. (Jacques Joseph passed away in 1934. It is entirely possible Romo is his incarnate.)

As it turned out, Romo diagnosed Renata with hemifacial microsomia, meaning one side of her face was underdeveloped (though it’s hard to say if this is true). She also had a deviated septum, which was corrected; her nose, shortened and straightened, was balanced with a chin implant. Her mother, initially flattened by her child’s chronic shame, was grateful. Renata, a long-limbed teenager whose nose was only markedly distinctive in the way that many teenagers’ ever-changing features are, was happy. She smiles shyly in her post-op portraits, seeming more relieved than explicitly confident—proof, maybe, that a smaller nose was for protection and peace, not newfound personhood. She started attending school.

Caption colour nose

Anna Pogossova, Self Portrait with Rhinoplasty Simulation, 2016, plaster, digital collage

On the landscape of the face, the nose can take up significant real estate, and in fact possesses a kind of secret magic: if it is ‘balanced’ with the face’s other features—according to whatever golden ratio symmetry is at play—then it goes relatively unnoticed, leaving the eyes or the smile to do their bidding, to take up space. The nose, to some effect, disappears. When it deviates from these relatively arbitrary confines, however, it becomes noticeable, noteworthy (nose-worthy)—the kind of thing worth pointing out if you’re especially mean. The nose is always irrelevant, until it’s not.

As long as there have been visual signifiers, there have been methods to fit them to capricious schemas. The mythos of the nose,and its association with fundamental personality traits, is as much a part of the collective psyche as the stories in which they’re featured. If they’ve large nostrils, fairytale and Disney villains alike need no introduction. In Slavic folklore, Baba Yaga is a witch whose nature is rather ambiguous—but her appearance is frightening, due in no small part to her massive nose. Snow White’s witch, youth-obsessed and evil as hell, has a hooked nose, reddish and dotted with a wart, and it rises and falls with her cackles, allowing us to literally see the malice on her face. Pinocchio had a button nose until he began to lie.

Related to this idea is the singularly cruel depiction of the nose as foreteller of its owner’s ethnic background and, as such, their potential stupidity. During eugenics’ early 20th century heyday—when schools of thought were dedicated to the practice of using, say, a sloped forehead to predict criminality—American physician Samuel George Morton, one of the founders of the Pennsylvania Medical College, determined that brain size was akin to head shape. Naturally, Morton believed that the capacity of the cranium was directly proportional to intellectual ability, and in Crania Americana, he writes, “The Caucasian race … is distinguished for the facility with which it attains the highest intellectual endowments … In disposition, the Negro is joyous, flexible, and indolent, while the many nations which compose this race present a singular diversity of intellectual character, of which the far extreme is the lowest grade of humanity.”

But no other Jewish body part is examined with such unique preoccupation as the nose.

It’s fair to say that anti-Semitism—anti-most cultures, really—is the bedmate of anti-Blackness, given the negative portrayal of Jews’ ‘swarthy’ skin in similar literature. But no other Jewish body part is examined with such unique preoccupation as the nose. Julius Streichers’ anti-Semitic children’s book Der Giftpilz, published in 1938, features a Little Karl, a young boy who states, “‘One can most easily tell a Jew by his nose. The Jewish nose is bent at its point. It looks like the number six. We call it the ‘Jewish six.’” In Notes on Noses, an 1854 book on physiognomy, George Jabet—the nom de plume of Eden Warwick—writes: “The Jewish nose … is very convex … It indicates considerable shrewdness in worldly matters; a deep insight into character, and facility of turning that insight to profitable account.”

It is easy to forget, then, that the nose’s primary purpose is to smell.

I’ve loathed my own ‘Jewish nose’ since I gained the cognisance to know I had one. My background is as mixed as any Brooklyn- born child’s, though my only ethnic role model might be the Puerto Rican-Jewish Juan Epstein, Welcome Back, Kotter’s resident gym-class-absconder. My facial features are objectively large, particularly my nose, which resembles the parts of the landscape visible from an airplane somewhere between Texas and California: raised, round, almost undulating. It’s a nose that reveals a lot of history, a nose that prompts (invariably Gentile) strangers to ask if I’m Jewish. Interestingly, it is unlike any other in my extended family. My paternal grandparents survived Auschwitz, and even their noses have a daintiness that mine does not. As a child, it rendered wishing for smaller-nosed ancestors useless. Had it come true, it might not have mattered: a big, unattractive nose was my fate. I applied ice to my nose at night, hoping to freeze enough blood vessels to shrink it.

Learning about my fraught appendage’s purpose—to help me understand and experience the environment—I felt robbed. Its destiny seemed reversed, revealing my vulnerabilities to others in a way far more potent than whatever information it afforded me. The ability to smell felt less a priority than not appearing decisively ugly. Truth be told, my gawkiness was an intrinsic thing (that would never fully fade with time) and could not be wholly attributed to one feature. But the less my nose became the reason for my perpetual discomfort, the more it became its proof. Bullies nor teachers, I knew, had no reason to lie. The tale of my beak followed me into young adulthood: “You’d be beautiful if not for your nose,” said well-meaning friends. “I can tell that you’re black and Jewish, mostly because of your nose.” (My maternal grandmother, Afro-Caribbean, a Jewish convert, named for an island to which Napoleon was exiled, rustles in her grave.) My nose became a hurdle that could not be jumped, the final obstacle in my path.

Truth being stranger than fiction, Jacques Joseph was Jewish himself. In Engineering the Human: Human Enhancement Between Fiction and Fascination, Theo Mulder writes, “[Joseph’s] form of surgery … had nothing to do with beauty ideals but with the desire not to stand out, or at least not to look Jewish and as a consequence suffer insults and persecution.” Across the sea in New York, around the same time as Joseph (or perhaps even earlier), Dr John Orlando Roe performed surgeries to correct ‘pug noses,’ a chief complaint of Irish immigrants who wished to appear more American.

Is there no oppressive undertone implied in the idea that a feature can be refined—that there is a final form?

After months of poring over information on the newish field of ethnic rhinoplasty, I am sitting in an office in New York, waiting for a consultation with a doctor who does not specialise in ethnic rhinoplasty at all. I graduated college just a few weeks before. Despite the sticky terminology, ethnic rhinoplasty is actually considered a mark of progression in the field, its appeal founded in ideas about racial sensitivity and ancestral integrity. The ideal patient wants a smaller nose, without the erasure of their ethnic history—not a one-size-fits-all ski-jump.“His patients want to attain balance and symmetry without eliminating their ethnic heritage and identity,” reads one surgeon’s manifesto (his post-op patients look, indeed, much like their ‘before’ selves). The goal here is a nose that closely resembles its former incarnation, minus the perceived flaw. Ethnic rhinoplasty implies the possibilities inherent in the The Beloved’s 1993 video for ‘Sweet Harmony’: gorgeous people of varying races, nary an offensive feature to be seen. “The most beautiful face is the most average one,” a classmate once told me, quoting her plastic surgeon. I think about it. Is there no oppressive undertone implied in the idea that a feature can be refined—that there is a final form? Is every smoothed hook and thinned nostril a step toward Anglicisation—or is it even fair to ask that when a white patient has no real right to enter the space of ethnic anxiety? What if ethnic plastic surgeons feel the enemy is not the patient’s ethnicity, but rather ugliness itself, which has no race? (Does it?)

Caption BW nose

Anna Pogossova, Self Portrait, 2016, plaster, digital collage


I don’t know, and anyway, I can’t afford it. Given the fine-tuned nature of their craft, ethnic plastic surgeons are expensive, and I am too old to write to the Little Baby Face Foundation in search of my own Dr Joseph. The room at the medical center is peach and inoffensively drab, as medical centers are wont to be. The colourlessness of doctors’ offices, designed for neutrality, has become so associated with the nervousness of the waiting room before that it often has the opposite effect. There’s a water fountain, and my father, who has accompanied me to the visit, seems to have jammed the spout. His cup is overflowing, and he is scrambling to get more containers to catch the flow.

A woman with taut skin is chuckling. We are not supposed to be here.

When the surgeon meets with me, I learn that while my eyes are “exceptional,” my face is basically average, but my nose is not, which has made the whole of my visage unfortunate. He determines that my nose is comprised of so much cartilage, so much fat, that it could give under the weight of its own flesh during surgery, causing me to temporarily stop breathing. “This could happen later in life anyway, without surgery,” he warns. He touches the interior of my left nostril, where the cartilage is thicker. “It’s hanging heavy in there.”

In an article entitled ‘The Upside of Ugly’ for The Nation, writer Jessica Valenti responded to young Ilse’s otoplasty, frustrated. It’s not that all girls ought to succumb to the culture of self-love, Valenti argues. It’s better they grow keen to the very specific concepts of beauty embedded into the culture and when, by fate of their birth, they cannot conform to them, they need not kid themselves. Instead, they should get rightfully angry and eschew a set of standards that excludes some and boosts others, self-empowering ‘I am beautiful!’s be damned. In a story for The Atlantic, Ta-Nehisi Coates agreed and disagreed: “I don’t know if we can create a culture without beauty, nor do I know if we should,” he says. “Trying to turn the culture away from the mockery … of young people is a good thing … We can work on two fronts—reforming the collective culture and empowering the individual.”

I don’t feel empowered when I look in the mirror, but while the risk of nasal collapse during rhinoplasty was small and easily amended, it was still one I didn’t wish to take. My nose is too big to shrink. For a year after my consultation, I kept the disc with my projected post-op images (Option A, a more natural look; Option B, a smaller, squared-off version of A). I never looked at them again, but the disc was decorated with statues of Greek gods and goddesses, eponymous, holy beings in nameless, clip-art form. Packaged this way, the extraordinarily beautiful is banal and dull, and there’s no indicating what the statues denote, what it is they intend to sell. The stone-faced gods have nothing to aspire to. This, to me, feels comically poetic.


Anna Pogossova, Self Portrait with Rhinoplasty Simulation, 2016, plaster, digital collage


Anna Pogossova, Self Portrait, 2016, plaster, digital collage

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