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Most historians agree that the first recorded account of reconstructive plastic surgery on the living is found in ancient Indian Sanskrit texts. These texts describe procedures to repair noses and ears that were lost either as punishment for crimes or in battle. Sushruta was a physician that made important contributions to the field of plastic and cataract surgery in 6th century BC. Shamina traces its antiquity in other ancient civilisations, in the first part of the three-part in-depth research, in the weekly column. A Different Truths exclusive.
Plastic surgery, the practice of reshaping body tissues for reconstructive or aesthetic purposes dates back to the antiquity. The types of plastic surgery and augmentation procedures we see today were already used by surgeons back in the early 1800s. Derived from the Greek plastikos, meaning “to mould,” plastic surgery holds a critical place in cultures all over the world.
Although the tools and techniques used in such surgeries have evolved dramatically over the past few decades, the basics of such surgeries are still the same as in the 18th century.
People have always been concerned about their outer appearance since the beginning of civilisation. To offer such people a better look, doctors of the ancient times also took the efforts to find out new ways of performing aesthetic surgeries.
In those times, piercing, scarification, and tattooing were quite popular. People used specialised techniques to change their looks in a better way, such as injection, ripping, snipping and stitching to make body parts look beautiful and smooth. This is also how reconstructive surgeries were born.
The History of Cosmetic Surgery
For centuries, tribes would disc their lips, stretch their earlobes, bind their feet, file their teeth, and tattoo and scar their skin. The oldest cosmetic surgery practices may date back to Egypt in the third millennia B.C., where early accounts describe rudimentary surgical procedures performed to repair facial trauma, including mandibular and nasal fractures.
Ancient Egypt
While the Egyptians did not practice extreme forms of plastic surgery on the living, they would often 
prepare their dead using principles of plastic surgery. For example, Ramses II’s mummy was surgically altered by having a small bone and a handful of seeds inserted into his nose to ensure that his most prominent feature would be recognisable in the afterlife. The mummy of Queen Nunjmet also had bandages stuffed in her cheeks and belly in the same sense that modern plastic surgeons implant silicone into a body. Treatments for the plastic repair of a broken nose are first mentioned in the Edwin Smith Papyrus, a transcription of an Ancient Egyptian medical text, some of the oldest known surgical treatise, dated to the Old Kingdom from 3000 to 2500 BC. While the Edwin Smith Papyrus shows that the Egyptians had skills to perform similar surgical procedures on the living, there is no solid documentation that is was actually done. Scholars suggest this reluctance to perform plastic surgery on the living was due to the Egyptian belief that one’s face remained the same in the afterlife and, therefore, should remain recognisable even after death (DiBacco 1994).
Ancient India: The Birthplace of Plastic Surgery
Most historians agree that the first recorded account of reconstructive plastic surgery on the living is found in ancient Indian Sanskrit texts. These texts describe procedures to repair noses and ears that were lost either as punishment for crimes (such as adultery) or in battle.
Sushruta was a physician that made important contributions to the field of plastic and cataract surgery in 6th century BC. Hindu surgeon Sushruta, working near the modern-day city of Varanasi described the “attached flap” method of plastic surgery in his 600 B.C. text Sushruta Samhita. The procedure involves reconstructing the nose by cutting skin from either the cheek or forehead, twisting the skin skin-side-out over a leaf of the appropriate size, and sewing the skin into place. To keep the air passages open during healing, two polished wooden tubes would be inserted into the nostrils. This method became known as the “Indian Method of Rhinoplasty” and was kept secret for centuries in India (Haiken 1997).
The medical works of both Sushruta and Charak originally in Sanskrit were translated into the Arabic language during the Abbasid Caliphate in 750 AD. The Arabic translations made their way into Europe via intermediaries. In Italy, the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) became familiar with the techniques of Sushruta.
British physicians travelled to India to see rhinoplasties being performed by native methods. Reports on Indian rhinoplasty performed by aKumhar Vaidya were published in the Gentleman’s Magazine by 1794. Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods. Carpue was able to perform the first major surgery in the Western world by 1815.Instruments described in the Sushruta Samhita were further modified in the Western world.
Ancient Rome: Plastic Surgery and Roman Baths
By the first century B.C., Romans were also practicing advanced plastic surgery procedures, perhaps prompted by the very public Roman baths. In a culture that praised the beauty of the naked body in both art and poetry, Romans viewed any abnormality, particularly the genitalia, with suspicion or even amusement.
Consequently, one of the most popular plastic surgery procedures appeared to be circumcision removal, which is described in a rather detached way by the Roman scholar Aulus Cornelius Celsus’s text De re medicina during the reign of Tiberius (A.D. 14-37). Celsus even describes a “breast reduction” surgery on an obese man whose breasts were “unsightly” and “shameful.”
Roman surgeons would also remove scars – particularly those on the back, which were marks of shame because they suggested that a man had turned his back in battle or, worse, he had been whipped like a slave. The poet Martial (A.D. 40-104) suggests that some slaves during his time had their brands removed by surgeons, but he gives no details of the procedures. Surgeons would often operate on gladiators who had noses and ears chopped off and on foreigners who would try to fit into Roman society.
[To be continued]
©Shameena Abdurahiman
Photos sourced by the author from the Internet.
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