The history of rhinoplasty, from the writings of Sushruta in 500 BC to the present, is discussed. The interest shown in plastic surgery was sporadic for several thousand years and punctuated by peaks of interest stimulated by the attainments of the Brancas and Tagliacozzi. A stagnant period of 200 years ended with the revival of the art as a result of a letter published in the Gentleman's Magazine of London in 1794. The influence that this description of a forehead flap reconstruction of the nose had on Joseph Carpue and European surgeons, and the effects it had in modern times, are noted. The introduction of cosmetic surgery by Roe, Weir and Jacques Joseph, and the enormous influence of the latter on modern concepts are outlined. The psychosocial aspects of rhinoplasty as it affects the patient and surgeon are discussed, and the challenges facing the discipline evaluated.