Plastic surgery has its origins in India. Many of the procedures which we feel are revolutionary have in fact their roots in ancient India.
There has been recent controversy regarding face transplantation and the ethical issues regarding its use. However, in Ancient India, reports of Lord Shiva attaching an elephant’s head to his own sons head predates the Vedic times by 4000 years. Perhaps not a true face transplant but a self face transplant, but Ashwini Kumars replanted the severed head of Yagna as well. These concepts clearly were introduced into India history and have inspired facial transplantation on certainly at least a cultural level.
The Ayurveda (science of life) was taught by Sushruta in 600 BC. He wrote the Sushruta Samhita, perhaps the earliest and greatest surgical and plastic surgery book. It describes a variety of local flaps which are currently still used successfully in facial plastic surgery. He describes how to reconstruct a nose with either a cheek or forehead flap, how to pierce and repair an earlobe, and chapters on skin grafting, wound healing, and burn care.
The “Indian Rhinoplasty”
The nose and nasal reconstruction bear special mention. The nose has always played a significant role in India symbolism. The Indian nose varies tremendously and provides a unique appearance to everyone of the subcontinent. It is commonly pierced and jeweled to provide further accentuation and charm.
In ancient Indian times, an adulterer’s nose would be amputated, certainly a difficult problem to reconstruct.
The Indian Rhinoplasty was created. Sushruta describes:
- The leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be gathered,
- A patch of living flesh, equal in dimension to the preceding leaf should be sliced off from the region of the cheek.
- After scarifying the severed nose with a knife, the flesh is swiftly adhered to it.
- Insert two small pipes in the nostrils to facilitate respiration and to prevent flesh from hanging down.
- The adhesioned part is dusted with the powders of Pattanga, Yashtimadhukam and Rasanjana pulverized together.
- The nose should be enveloped in Karpasa cotton and several times sprinkled over with the refined oil of pure sesamum.
- When the healing is complete and parts have united, remove the excess skin.
Even in those days he had emphasised the accurate cutting of the pattern to the size of the defect, the accurate cutting and suturing of the flap to the nose and maintenance of airway with tubes.
Tibhrovandas Motichand Shah published “Rhinoplasty” in 1889. It was provided a modern adaptation of Sushruta and for the first time describes anesthesia in the reconstruction.
“The nose should fit the face”
A strong jawline would suggest a stronger nose.