Modern Tale about Big Nose

Nose is a symbol of dignity, hence one of the most important parts of human’s body, wrote Ryunosuke Akutagawa, the Japanese author of short story “Hana” (“The Nose”). The nose fascinated also Nikolai Gogol: the Russian author imagined a nose leaving the face it was attached to and develop its own life in the streets of St. Petersburg. But according to the modern thesis about nose, it is a part of body that can define women’s attraction. In the Caucasus a small and attractive nose is a rare gift, but a big one is the best present for a plastic surgeon.

The plastic surgery is increasingly popular in Georgia: six professional plastic surgery clinics can be counted in the capital and two in Batumi and Kutaisi Plastic surgery started gaining popularity about ten years ago. Georgian plastic surgeons begin to improve their qualification in the clinics of The USA, Germany and France. The first plastic surgery in Georgia, done in 1970ees by oto-rhyno laryngologist Vakhtang Khutsidze, was rhino plastic. Since 70ees it has became the most popular surgeon operation in Georgia and, even, in The Soviet Union.

According to the Georgian plastic surgeon Iva Kuzanovi, nowadays nose jobs are followed by breast implants, liposuction, abdominoplasty (also known as tummy tuck) and plastic recovery of hymen. The latter is controversial: despite being the cheapest, an average of 650 GEL, some surgeons do not perform it for moral reasons.

“It was very popular until five, six years ago,” explains Lela Osikmashvili, financial manager of clinic Kuzanovi. “Every year the number of customers decreases, but this operation has its own clients yet, they are women between 20 and 35 years old. It’s difficult to say who they are, I mean where they come from, but I think that majority aren’t from Tbilisi.”

N. is 30-years-old lady, she comes from Gavazi, eastern Georgia. She talks about her experience on condition of anonymity. Her story is common – boyfriend, lies, promises about marriage, other woman, abandonment. Two years ago she decided to get the hymen reconstructed.

“Do you want to know why I decided to do it?” she asks. “We live in a society with very stern moral rules. We live in a strict orthodox society where every woman should be a virgin before marriage. My tragedy was my mistake, I just tried to improve it a little bit,” she explains

There are cases in which women decide to undergo the surgery more than once, says Osikmashvili. She remembers woman, recovering her virginity eight times. “This is a fallaciousness of our society,” says Kote Matitashvili, “there more important plastic operations, it’s not necessary to waste time on this foolishness,” concludes the surgeon at Caraps Medline clinic who, despite the little time the hymen reconstruction requires (less than 10 minutes), refuses to perform it.

Though shocking, the hymen reconstruction is uncommon, with about 80 percent of the plastic surgeries going to reshaping the nose for prices varying between 2,000GEL and 5,000GEL. Liposuction costs from 1000 to 3000 GEL, the price of breast implant begins from 2000 GEL and the maximum is 6000 GEL. As for abdominoplasti, it costs from 3000 to 6000 GEL. The prices are almost equal in every clinic. Sometimes there is difference only in 200 or 300 GEL.

"Every operation has its own age category.” explains Matitashvili “Nose and ear job are popular among men and women between 16 and 30 years. Liposuction customers are women over 30. As for breast implant and lips implant, there is no age limit, they all want them.”

Although men are also starting to use cosmetic surgery, 95 percent of the patients remain women “Plastic surgery is very expensive satisfaction...” he says “...in Georgia as in the West. Despite the economic crisis, the number of customers increases rapidly and one in ten patients returns for additional treatments.”

Sociologist Maia Bakhtadze, 26-years-old, was 19 when she made up her mind for a nose job. Two years later she decided to do it again, she claims she was disappointed. After her first pregnancy, Maia had liposuction and a breast implant in the different clinics. Now, after the second pregnancy, she’s planning to go for the plastic surgeries again, in spite of the prices.

“I don’t think that I’m addicted,” says Maia, “every woman has to take care of her appearance. I have no claim to doctors, although, treatments are far more expensive here than in the US or Europe. Anyway, plastic surgeon is one of the most successful fields of the modern medicine in Georgia.

Osikmashvili and Marina Sakvarelidze, the manager of Woman and Health’s clinic do not share this view. “Plastic surgery is expensive,” she agrees, “but Georgian prices are in line with those in Western Europe and the US.”

“Take sex change, one of the most expensive and difficult operations,” Osikmashvili points out. “It’s cheaper here in the US.” Sex change is a complex process as it requires preparation and psychological support and the price tag shows it: between 25,000 and 30,000GEL. But in Georgia requests are few, “you can count them on one hand,” surgeons say. A search on the internet shows that, on average, US clinics advertise sex change processes for $13,000 to $16,000.

Iva Kuzanovi performed the Caucasus’ first sex change in 1996: a young Georgian woman who wanted to be a man. It was a shock for Georgia’s public opinion. Osikmashvili says that Kuzanovi’s clinic has had four patients who changed sex since then and fourteen are under observation, eight of them are not Georgian citizens. If the customers of sex change operation in the world are as men, so women, only females “dare” to change their sex in Caucasia.

Mr. Kuzanovi considers that sex change operation is one of the most important achievements of plastic surgery. The preparatory procedure is quite difficult. The group of experts, including psychologists and endocrinologists, aims to determine which hormones are dominant in the body – androgens or estrogens, male and female hormones. Only after this procedure, patient is allowed to go under the sex change operation. This later has two stages of operating: the first stage implies an amputation of breast and female sexual organs and the second one means to make a penis implant.

“It’s proved, people, feeling that eternally they have another sex, in age of thirty or maybe earlier they commit suicide.” Mr. Kuzanovi explains.

The August 2008 war affected also the plastic surgery business as the number of foreigners who would arrive to Georgia for treatment has decreased. “
Clinics do not disclose their numbers. Revenues are as confidential as their patients’ names. The pride of a perfect nose makes clinics’ profitable businesses.

“Our plastic surgeon David Tsitsishvili is very famous doctor in the post soviet countries,” explains Sakvarelidze. “He lives in Moscow and come to Georgia every two months. Nose jobs only can bring in up to 50,000 GEL in three weeks.”

Plastic surgeons have their rivals though. At the Mikhailovi clinic, or the 9th hospital of Tbilisi, oto-rhino laryngologists can perform rhino-plastic along with tonsils and nose polyps. Vakhtang Khucidze is a laryngologist and the first surgeon who established the institute of rhino plastic

“We’d been performing rhino-plastic long before cosmetic surgery clinics arrived in Georgia,” he says. “We are not plastic surgeons. I’ve never done a liposuction. We do have our patients, though some people prefer to come to hospitals than a clinic.” The price-tag attached helps: 500 to 800GEL.

No problem with that, explains Matitashvili, as he sees these public facilities’ doctors competent enough to perform a rhino plastic.


The history of plastic surgery dates with 6th century BC. The old Indians invented technology of nose reshaping, transplanting skin from the leg to nose. But the majority of plastic surgeons consider that the first plastic operation has been done in 1904 by Jack Jasef. In his book about plastic surgery Iva Kuzanovi writes:


Rhyno plastic in India

“Rhyno plastic is the oldest plastic operation, devised 2 600 years ago in India.”

In ancient time, people believed that nose can define people’s fate. Big and aquiline nose was considered as a sign of fortune. Times have changed. Today people are skeptics and if nature attached a big nose to your face better to entrust it to the skilled hand of a plastic surgeon than believing in ancient superstition.