Your Nose: A History of the Nose, Rhinoplasty and the Attitudes that Shape Our Perception, in Five Parts (Excerpted from Dr. Adamson’s book Fabulous Faces, available on Amazon.com, and edited for our blog.)

Part 1: Why Your Nose is a Sexy Beast
History is full of superstition, rash judgments, and pseudoscience about the nose. There was a long-standing belief that an individual’s character isn’t just stamped on his or her face but spelled out in the lines and contours of the appendage on the front of his or her face.

So the nose carries with it a lot of excess baggage. No wonder it’s one of the most psychologically loaded of all the body parts. And it’s not just about intelligence and personality. It’s also about something far more primal: sex. The eyes may be the windows of the soul, but the nose is the face’s true sexy beast.

In their book on the psychological effects of plastic surgery, John and Marcia Goin (one a surgeon, the other a psychiatrist) rank the nose with the breast and the penis as the most important organs in terms of psychology and sex. The nose, it’s argued, is a secondary sex organ. Consider this: The male nose is one of only two protruding midline anatomical structures. It undergoes a growth spurt at adolescence, and it emits a sticky mucous substance. Sound familiar? The nose and the penis have much in common.

But the comparisons don’t stop with males. In breathing, the nose is primarily receptive—like female genitalia. It’s a cavernous structure that sometimes bleeds. Beyond that, it sometimes becomes stuffy after sex, causing so-called honeymoon rhinitis.

Over the centuries, doctors have equated the nose, fixations with the nose, and problems with the nose (including runny noses) with various kinds of sexual dysfunction. Glaser tells of German doctor Wilhelm Fliess, a late nineteenth-century ear, nose, and throat specialist who argued that the nose has its own form of menstrual cycle. Fliess claimed that “genital spots” in the nose grew swollen with “sexual substances” once a month. This, he believed, caused a kind of sexual hysteria. His treatment involved a snort of cocaine. If that didn’t work, he followed up with the surgical removal of part of the nasal bone. The great Viennese psychoanalyst Sigmund Freud befriended Fliess, shared cocaine with him for his own stuffy nose, and even referred one of his patients to Fleiss for this surgery. It went badly, and the patient almost died. Such was the preoccupation with the nose. Others blamed it for all kinds of physical, emotional, and mental problems, including retardation. Children with stuffy noses and children who breathed through their mouths were judged as “slow” and, worse, more likely to masturbate.

The nose has always been symbolically sexual, a genital equivalent, say the Goins. But the sexual connection isn’t just symbolic. Way in the back of the nose sits the tiny vomeronasal organ, which is mainly used to detect pheromones, chemical substances that humans and other animals produce to stimulate behavioral responses in others of the same species, including powerful sexual signals. When couples talk about having “good chemistry,” they may not know it, but they’re most likely responding to each other’s pheromones. In histology, the science of organic tissues, the mucous membranes of the nose closely resemble erectile tissue in the male genitalia. Viewed this way, the nose and the penis are first cousins.

It’s no wonder, then, that psychiatrists’ couches are full of people blaming sexual problems on their noses. It’s called displacement. For plastic surgeons, initial meetings with prospective rhinoplasty patients are critically important. For example, if someone in middle age has only just started disliking his or her nose, this can be a huge red flag for the plastic surgeon. It may not be the nose he or she hates. It may be something else, something connected with sex, a failed relationship, a concern about sexual performance, or even a concern about sexual identity. The study of the nose abounds with a bizarre combination of fact and fiction. Emotional and sexual problems often seem like one and the same. But it’s possible to get carried away in making the connection.

Half a century ago, professors at an American university looked for a link between garden-variety nasal problems, such as stuffiness and sneezing, and depression and anxiety. Their case studies, as Glaser reports, bore telling titles. One was called “Chronic Disease of the Sinuses and Vasomotor Rhinitis in an Anxious, Dissatisfied, Frustrated, Resentful Woman who Based her Security on her ‘Good Looks’ and ‘Sexual Assets’, and Who Feared She Was Losing Both.” Another was titled “Nasal Obstruction in an Insecure, Dependent, Ambitious, Lachrymose Man.” You get the idea. The authors, Glaser says, claimed there were “clear links between humiliation, rejection, anxiety, and dejection to everything from runny noses to sinus disease.”

Next week we will explore The Preoccupation with Your Nose!