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In 1914, a young woman who had always been self-conscious about the appearance of her nose decided to seek the advice of a surgeon. Her physician, Jerome Webster, made the following diagnosis: "Nose is fairly long, has a very slight hump, is somewhat broad near the tip and the tip bends down, giving somewhat the appearance of a Jewish nose." Echoing the perspective of a generation of surgeons, Webster concluded, "I think that there is sufficient deformity to warrant changing the nose."1
For over a century, the term the "Jewish nose" has been used in Western scientific literature to describe a set of physical features thought to constitute a distinct, race-based deformity. As early as 1850, Robert Knox, a prominent anthropologist, described the physical features of the Jew as including "a large, massive, club-shaped, hooked nose, three or four times larger than suits the face. . . . Thus it is that the Jewish face never can [be], and never is, perfectly beautiful."2 In the 1900s, the "Jew nose" became the subject of purportedly scientific studies of hereditary transmission; a 1928 text described a "Jew nose" that emerged in the offspring of mixed Jewish and non-Jewish marriages, for example.3
By the early 20th century, physicians were arguing that surgical procedures to alter "racial characteristics" such as the "Jewish nose" could be a means of promoting patient well-being. In 1930, William Wesley Carter noted that "the modification of accentuated family or racial characteristics, such as are sometimes observable especially in Semitic subjects . . . is frequently of great importance to the individual."4 Another surgeon, Vilray Blair, argued in 1936 that, due to prejudice against Jews, "change in the shape of the pronounced Jewish nose may be sought for either social or business reasons."5
The persistence of this charged category in the medical literature raises some important questions about the medical profession's role in perpetuating racial and asthetic prejudices. By incorporating this term into their clinical vocabulary, early plastic surgeons unwittingly lent scientific credibility to popular stereotypes about beauty and ethnicity. In this way, the "Jewish nose" was transformed from a facial variation into a specific, pathological condition for which there existed a medical protocol for correction.
At the same time, however, plastic surgery's appropriation of this term can be seen as a reflection of the fledgling field's own need for professional and social credibility. Noting that many patients dismissed plastic surgeons as so-called beauty quacks, a professor of surgery at Johns Hopkins was driven to argue in 1927 that "a beauty surgeon works strictly on a commercial basis . . . [while a plastic surgeon] is . . . one who has the ideals and education of [the medical] profession."6 Such surgeons were anxious to convince both patients and other physicians that they were not simply catering to the vanity of the public, but addressing "scientifically" defined deformities that could have great economic and emotional costs for their patients. The incorporation of terms such as "Jewish nose" into the medical lexicon was therefore consistent with the specialty's struggle to solidify its professional status.
Today, some plastic surgery texts continue to describe the "Jewish nose" as if it were a standard physical deformity requiring surgical correction. A 1996 manual describing procedures for altering ethnic noses, for example, indicates that correction of the "Jewish nose" requires "a classic rhinoplasty with lowering of the dorsum, narrowing of the bony pyramid, refinement and elevation of the excessively long hanging tip."7Another recent manual, while refraining from explicitly using the Jewish nose as a diagnostic category, notes that 2 patients with noses that "have acute nasolabial angles, plunging tips, or foreshortened nasal tip pyramids" were "of Jewish ancestry" or of "Jewish descent."8
However, changes in attitudes toward ethnicity and beauty have caused many plastic surgeons to rethink earlier approaches to physical features associated with ethnicity. In the words of a recent rhinoplasty text, "it is neither feasible, desirable, or possible to transform totally an Asian into a Caucasian or vice versa. . . . Nor is it advisable to transform a Black nose . . . into an aquiline nose better befitting the classic British butler."9 Furthermore, recent reports suggest that many patients who elect to have plastic surgery for asthetic reasons are themselves expressing a specific desire to retain signs of their ethnic identity.9
The conflict over the use of the term "Jewish nose" can be seen to reflect a broader controversy about the role of medicine in either altering or preserving ethnic uniqueness. Both in the past and in the present day, cosmetic surgeons have been sought by patients wishing to alter features thought to separate them from the mainstream. By developing medical vocabulary and procedures to respond to these concerns, physicians may not be able to avoid complicity with the social and esthetic prejudices they reflect.
Preminger B. The "Jewish Nose" and Plastic Surgery: Origins and Implications. JAMA. 2001;286(17):2161. doi:10.1001/jama.286.17.2161-JMS1107-5-1
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