Since the whole story is premised on the magical disappearance of Kovalev's nose, it would be difficult for the effect to be equaled through any photographic realism. The tale would have to be changed into something entirely different, with the meaning and the themes unlike what Gogol evidently intended.
But what are the themes? Could "The Nose" have been intended by the author as just a huge joke, where he would watch the literary world run around in circles trying to discover the meaning? Probably not, but if it's a satire, Gogol appears to be aiming, for one thing, at the general ridiculousness of our concern about appearances. In today's world we might view Kovalev's situation quite differently than Gogol's first readers would have done, since a person can actually have part of their face surgically removed due to cancer. But what gives "The Nose" its odd humor, then and now, is that no one, including Kovalev himself, seems to react with the degree of astonishment and amazement one would think the events of the narrative would cause. The story anticipates Kafka's "The Metamorphosis," for in both cases the victim of a strange transmutation finds the outside world basically unsympathetic and alienated from the victim's misfortune. That said, Gogol's story is much lighter in tone. The main point doesn't seem to be alienation in "The Nose" so much as simple absurdity. The magical removal of Kovalev's nose, its apparent masquerade as a person, and then its equally bizarre restoration to his face are emblems of the inexplicable nature of human events. Life goes on as it normally does around Kovalev. Also (though this may not have been intended by Gogol as a significant point) no one seems to attribute the events to divine intervention. At the very start of the tale when Kovalev's barber Ivan first discovers the nose embedded in bread, people are at a loss even to ask the most obvious questions. If the nose was somehow sliced off, for instance, why isn't there any blood? People's unscientific, obtuse reactions are Gogol's metaphor of the unthinking and irrational qualities of human behavior.