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Because interest in beauty is more than skin deep — it’s age-old.

The nose and face have played a prominent, even Cyrano-esque, role in India’s history — from the Hindu god Shiva transplanting an elephant’s head on his son Ganesh to the enormous running nose of Saleem Sinai in Salman Rushdie’s Midnight’s Children to facial decorations like nose piercings and the bindi (forehead dot). But few people realize that India’s surgeons actually invented facial reconstruction and plastic surgery about three and a half millennia ago. And for good reason too.

Indian physicians have been performing skin grafts, rhinoplasty and other plastic surgery techniques since 1500 B.C.E. The first detailed accounts of such procedures come from Sanskrit texts penned in the 6th century B.C.E. by the Hindu surgeon Sushruta that still form the basis of modern Ayurvedic, or traditional, Indian medicine.

Noses were particular organs of pride and respect for many men, and thus a frequent target in battle.

After noting that “wine should be used before the operation to produce sleepiness and even insensibility to pain,” Sushruta describes in great detail a rhinoplasty procedure in which a flap of skin from the patient’s cheek is cut and twisted skin-side out over the nasal cavity, where it is rolled over itself and attached over two wooden tubes in order to preserve the air passages. Sushruta also discusses how to dress and treat the wounds and related procedures like tissue grafting and fixing a harelip.

Procedures for repairing noses, ears and other lost or damaged body parts were also developed by Sushruta and others in ancient India for one very good reason: high demand.

As with Saleem Sinai, noses were particular organs of pride and respect for many men, and thus a frequent target in battle. For the same reason, amputating the nose was a common punishment (or revenge tactic) in ancient India for sex-related offenses — offenses which, back then, typically included only crimes committed against other men (like adultery) and not the numerous sexual assaults committed against women. And while the perpetrators of sexual assault today may deserve a good nose-shearing, thankfully — with the stiffer legal penalties for rape, stalking and voyeurism recently enacted by Indian lawmakers in the wake of several heinous sexual assault cases — such retributive measures may no longer be necessary.

But it’s not like India is hurting for plastic surgeons these days anyway–ranking fifth in the world according to the most recent survey from the International Society of Aesthetic Plastic Surgeons. India also enjoys an influx of surgical patients from both the West and countries such as Nigeria, Afghanistan and Iraq. And with quality and price a lure for foreign visitors in search of affordable nipping and tucking, India should thank/blame itself for what it wrought those many moons ago.

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Sean Braswell

Sean Braswell

Ozy Author SENIOR WRITER

Sean Braswell is a Senior Writer at OZY. He has five degrees and writes about history, politics, film, sports, and anything in which he gets to use the word “caterwauling.”