Plastic Surgery and Ayurveda

“A thing of beauty is a joy forever” – John Keats

Plastic surgery, the practice of reshaping body tissues for reconstructive or aesthetic purposes dates back to antiquity. Derived from the Greek ‘plastikos’, meaning “to mould,” plastic surgery holds a critical place in cultures all over the world. For centuries, tribes would disc their lips, stretch their earlobes, bind their feet, file their teeth, and tattoo and scar their skin.

If contemporary popular series such as extreme makeover and ‘tummy tuck’ are any indication, plastic surgery has not lost any of its cultural power. While filed teeth may not appeal to everyone, men and women of today still have a wide range of surgical procedures from which to choose, including liposuction, nose jobs, eyelid surgery and tummy tucks along with augmentation and reduction of certain body parts. The term “plastic surgery” also includes nonsurgical options such as botox, microdermabrasion, collagen injections, laser hair removal, and chemical peels. Plastic surgery, however, was not always so readily available or varied and was even shrouded in mystery and magic.

Ancient India: The Birthplace of Plastic Surgery

Just as the Sun rises in the east, the science of plastic surgery first dawned in the ancient Indian civilization. The earliest replantation was performed by Lord Shiva by attaching an elephant’s head on his son’s body (Ganesha) and by Ashwini Kumars’ who successfully replanted the severed head of Yagna. Thus the history of plastic surgery in India dates as far back or before the Vedic times nearly 4000 years ago.

Brahma, the creator of the universe evolved, Ayurveda (the science of life) by meditation and imparted it to Daksha Prajapati, who in turn taught the Ashwini Kumars’ (twin gods). Lord Indra, the celestial ruler, learnt it from Ashwini Kumars and in turn passed on the knowledge to many rishis, namely, Sage Bharadwaja (Guru of Atreya), and King Divodasa of Banaras (Lord Dhanvantri). Sushruta, who was sage Vishwamitra’s son, along with others approached Dhanvantri and requested him to accept them as his “shishyas” (disciples) and teach them the science of Ayurveda.

The ancient text ‘Sushruta Samhita’ is believed to be part of one of the four Vedas (part of Atharva-veda) and was written by Sushruta in approximately 600 BC compiling what he had learnt from his Guru Dhanwantri and his predecessors.

Nose Job Anyone?

Sushruta described rhinoplasty for a cut nose as follows:

  • 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 (Caesalpinia sappan, Brazil wood), Yashtimadhu (Glycyrrhiza glabra, licorice) and Rasanjana (Berberis asiatica, daruharidra) 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, the excess skin is removed.

Even in those days Sushruta had emphasized upon 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.

There was a second method of rhinoplasty in India as practiced by Tilemakers. This involved using a free graft from the buttock. The skin and the underlying tissue of the shape of the defect on the nose was beaten with wooden slippers and applied on the defect with some “cement”.

In the 4th century, another scholar named Vaghbata wrote ‘Ashtanga Sangraha’ and ‘Ashtanga Hridayam’. In Ashtanga Hridayam, he described rhinoplasty as performed by Maharishi Atreya and emphasized the need for the provision of an inner lining by turning down the nasal skin. The classical cheek flap rhinoplasty of Sushruta and Vaghbata was later modified by using a rotation flap from the adjacent forehead, as mentioned in The Traditional Indian Method of Rhinoplasty. This was kept a secret for centuries in India, and practiced by Marathas of Kumar near Poona, certain Nepali families and Kanghairas of Kangra (Himachal Pradesh).

 

Art of Rhinoplasty at Kangra, Himachal Pradesh, since 1440 AD

Those with cut noses and deformed noses due to leprosy and syphilis were operated by the Kanghairas (local healers) of Himachal Pradesh. The patient was given wine to drink to put him to sleep (since anesthesia did not exist in those days). A pattern of the defect was made on a paper. A handkerchief was tied around the neck to make the veins of the forehead prominent, and the flap was marked including the vein on the forehead (in the pedicle between the eyebrows). The forehead flap was folded in itself to form the inner lining.

 

The knowledge of rhinoplasty spread from India to Arabia and Persia and from there to Egypt and Italy in the 15th century. The first translation of Sushruta Samhita was done in Latin by Hessler in 1844 and in Arabic by Ibn Abi Usaybia (1203-1269 AD) and later into German by Vellurs. Bhishagratna translated it in English in 1907.

Even today, the western world gives credit to India for rhinoplasty called as the Indian Rhinoplasty. This of course, later received a few modifications, but the basic principles as laid down by Acharya Sushruta remain the same.

Ayurvedic surgeons at I-AIM healthcare center are well-versed and proficient enough to carry out these surgeries.

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