As early as 2000 BC, the ancient Egyptians attempted to “enhance” the features of mummies so that esteemed rulers could maintain their form even in the afterlife. They used small bones and seeds or bandages as rudimentary implants. Post-mortem modifications were carried out, for example, on the nose of Ramses II and the cheeks and abdomen of Queen Nunjmet. Fortunately, there is no clear evidence that similar practices were performed on the living.

Around 600 BC, the first records appeared of ancient Indians attempting the reconstruction of noses and ears. In those times, protruding parts of the body could easily be lost in battle or as punishment for criminal acts, such as adultery. Using a flap of skin from the forehead or cheek and a pair of wooden tubes, they attempted to restore a person’s facial aesthetic and the embodiment of character, which at the time was strongly associated with the nose. The Indians kept this method secret for many years, passing the knowledge down only from generation to generation.

Thanks to public Roman baths, the ancient Romans also began experimenting early on with correcting various abnormalities. Differences in the genital area or breasts could draw unwanted attention and astonishment. Under a strong patriarchal system, and with the cult of the beautiful male body celebrated in artistic and poetic works, circumcision was common, and the first breast reduction was performed not on a woman, but on an obese man. The procedure was described by the Roman scholar and encyclopedist Cornelius Celsus in his book De Medicina. Scar correction for wounds on the back was also sought after, as these scars were often a mark of abused slaves or cowards who had fled battle.

In 1597, Gaspare Tagliacozzi, a professor of surgery and anatomy at the University of Bologna, published the first book on nose reconstruction in response to a persistent syphilis epidemic, which often left victims without noses. His work initially received little approval, as contemporary religious and anti-Reformation movements believed that the consequences of this disease—especially in women—were a deserved punishment from God, and for many years his notes were “lost.” Today, however, they are available, and despite the fact that these reconstructed noses were far from perfect aesthetically and risked being blown away when sneezing, Tagliacozzi is now considered a pioneer of modern plastic and reconstructive surgery.