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Illustration of Sushruta treating a male patient
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India Plastic Surgery

Sushruta, Indian doctor of anesthesia and plastic surgery

Incisive India

The Birthplace of Plastic Surgery

Why you should care

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 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.

And it’s not like India’s plastic surgeons are hurting for customers these days. The most recent survey from the International Society of Aesthetic Plastic Surgeons ranks India at No. 8 in the world with over 466,000 surgical and nonsurgical (e.g., Botox) procedures performed every year. India also enjoys an influx of surgical patients from both the West and countries such as Nigeria, Afghanistan and Iraq.

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.

This OZY encore was originally published Nov. 21, 2013.

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Sean Braswell

Meet The Author Sean Braswell

Sean Braswell writes about history, politics, film, sports, and most everything else for OZY --aside from this byline, which he assigned to an unpaid intern who was locked in a room, given a Red Bull and an internet connection, and told to make some magic happen, pronto.

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