Back to the future: Nose jobs from ancient India

Plastic surgery is commonplace nowadays. From celebrities to the average Jane, everyone seems to be on a quest to surgically “help” their natural bodies along. Gossip magazines regularly indulge in “spot the surgery” in before-and-after celebrity photos.

But did you know that plastic surgery was first developed in ancient India, more than 2,000 years ago? It may seem astounding, but despite the lack of modern anaesthesia, modern drugs and modern tools that we feel are required for even minor surgery, ancient Indian surgeons could do all sorts of things, like rhinoplasty (the “nose job”), earlobe reconstruction, cataract surgery, cleft lips, delivery of babies by caesarean section and many others! Sushruta, an ancient surgeon, who lived in the 6th century BCE in Varanasi, composed a long and comprehensive Sanskrit text called the Sushruta Samhita, which details many different types of surgical procedures.

Sushruta Science and Technology Heritage of India Gallery – Science Exploration Hall – Science City, Kolkata (Source: Biswarup Ganguly/Wikimedia Commons)

(This is part of the series Make History Fun Again, where the writers introduce historical facts, events and personalities in a fun way for parents to start a conversation with their kids.)

Nose-talgia

Of all of the different surgeries described in the Sushruta Samhita, rhinoplasty was one of the most advanced methods and became famous throughout the world! In fact, in 695 AD, the Roman Byzantine emperor Justinian II actually got a ‘nose job’-by a travelling Indian surgeon, no less-when his nose was amputated upon his forcible removal from the throne and exile and within 10 years, he had regained his throne, a nose and a brand new nickname, Justinian II ‘Rhinotmetus’ (“Cut Nose”)!

In ancient India, there were a surprisingly large number of noses that needed reconstruction. Soldiers’ noses, symbols of pride, were common targets in battle. They were also frequently amputated as legal punishment for many crimes, including adultery.

Surgery 101

Sushruta tells the reader that a ‘careful physician’ should measure the size of the nose using a leaf, and then cut an equivalent amount of skin from the adjoining cheek, while keeping the skin attached to the face via a small flap. The stump of the nose should be made raw (to show up the living flesh underneath) by scraping with a knife. The physician should then place the cut skin of the cheek on the nose and stitch the two parts swiftly, keeping the skin properly elevated by inserting two tubes of eranda (the castor-oil plant) in the position of the nostrils, so that the new nose gets a proper shape. The physician should regularly clean the wound by sprinkling a powder of liquorice, red sandalwood and barbary plant, and keep it covered with clean cotton and sesame plant.

This classical version was later modified to use a flap from the forehead above the nose and was practiced for centuries and centuries afterward! In fact, during the Mysore War of 1792 between the British and Tipu Sultan, this Indian surgery was witnessed by British doctors, and published in the 1794 issue of the Gentleman’s Magazine of London, where it created quite a furore! A British surgeon, Joseph Carpue, learnt from this method and went on to do the first rhinoplasty in England, which became popularly known as the “Indian Nose”.

(For more fun journeys through India’s history, check out the newly released two-volume set, The History of India for Children Vol. 1 and Vol. 2, published by Hachette India, which is now available online and in bookstores across the country.)