Archives of Facial Plastic SurgeryVol. 4, No. 2 PerspectivesFree AccessJohn Orlando RoeFather of Aesthetic RhinoplastySamuel M. LamSamuel M. LamE-mail Address: samlammd@yahoo.comWilliams Center for Facial Plastic Surgery, 1072 Troy-Schenectady Rd, Latham, NY 12110Search for more papers by this authorPublished Online:1 Apr 2002https://doi.org/10.1001/archfaci.4.2.122AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail JOHN ORLANDO ROE (1848-1915) (Figure 1), an otolaryngologist who hailed from Rochester, NY, should be rightfully credited as the father of aesthetic rhinoplasty. Unfortunately, his contemporary, Jacques Joseph, has often been unjustly heralded as the proper bearer of this title.1,2 Although Joseph's contributions at the time to the nascent field of facial plastic surgery should not be underestimated, Roe's pioneering endeavors were truly innovative and clearly antedated Joseph's work by 11 years. Joseph, often curmudgeonly disposed, would turn irascible and flush a bright red when his rival's name was invoked in his presence—an incident that Aufricht recounted—and would infrequently and erroneously cite Roe's achievements.3 Unlike the prevailing extranasal technique of the day—which marked the patient's nose with multiple incisions and which differs radically from present, external techniques—Roe devised a unique intranasal approach that corrected the tip, or a "pug-nose" deformity, his findings of which were published in 1887, and the dorsum, or "angular deformities," which was reported 4 years later. His first article in 1887 demonstrated his technique with preoperative and postoperative illustrations (Figure 2), which Joseph would later adopt in 1898 with his single case study. Moreover, Roe's second article in 1891 was historic in the use of preoperative and postoperative photographs to document his findings (Figure 3), which Joseph would also use much later in 1902.Figure 1. John Orlando Roe, MD, 1848-1915.Figure 2. Illustrations "made from photographs" demonstrating the results of Roe's endonasal rhinoplasty from his 1887 article.Figure 3. Preoperative (A) and postoperative (B) photographs of a nasal hump reduction from Roe's 1891 article.John Orlando Roe, born in Long Island (Patchogue, NY) on February 3, 1848, was English by ancestry and traced his lineage to Revolutionary War patriots. He attended several institutions, including the Hudson River Institute, the Wilbraham Academy of Massachusetts, and the University of Michigan in Ann Arbor, and studied under the tutelage of a local physician, Dr Oliver Rice. He enrolled in medical studies at the University of Michigan and completed his MD degree at the College of Physicians and Surgeons of Columbia University in 1871. After a postgraduate year in New York City, Roe opened his clinic in Rochester, NY, to practice otolaryngology. He then elected to embark on a 2-year trip to Vienna, Berlin, and London to refine his training, during which time he received instruction from the renowned Sir Morill Mackenzie. After his return to Rochester, he established a busy practice and was a charter member and eventual president of the fledgling American Laryngological Association. He also became president of the Medical Society of the State of New York, the Central New York Medical Association, the Monroe County Medical Association, the Rochester Academy of Medicine, and the Rochester Pathological Society. Above all, he cherished the honorary LLD degree that his alma mater, the University of Michigan, bestowed upon him just 2 years prior to his death. In regard to his personal life, Roe was wed to Jane Pomeroy, and the union yielded 1 child, Janet Pomeroy Roe. He would die on Christmas Eve at his home in Rochester in 1915.Prior to the release of his seminal publication in 1887, Roe had already written extensively about the nose as an otolaryngologist, discussing the treatment of nasal stenosis, allergic nasal conditions, and his design of an original, nasal instrument. Roe was thoughtful in his determination to perform a conservative rhinoplasty free from scarring, a stigma that marked all prior reconstructive and cosmetic nasal operations, stating in 1887 that "Great care must, however, be exercised not to remove too much tissue, and also not to cut through into the skin, lest we may have afterward a scar or dent in the external surface of the nose." His early use of internal and external splints to conform the ultimate shape of the nose can be valued by the modern rhinoplasty surgeon. Beyond his technical and imaginative prowess, Roe was foremost an artist and frequently admonished his colleagues to exercise an aesthetic eye and not blindly subscribe to rigid rules of surgery. The psychological ramifications of an ethnic nose were significant, especially during the more hostile climate of the fin de siècle, and Roe appreciated these psychosocial issues and sought to lessen the cultural prejudices through his surgical manipulations.3Despite possibly unwitting efforts to the contrary, John Orlando Roe should be deservedly restored to his rank as the father of aesthetic rhinoplasty.
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Aug 18, 2023
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