The Sushruta Samhita

To rebuild a nose that had been cut off, the surgeon first cut a leaf or creeper to the size of the defect. Using it as a pattern, he sliced a matching patch of skin from the cheek to repair the nose. This passage is the best known in the Sushruta Samhita, a Sanskrit compendium of medicine and surgery in six sections and one of the founding texts of Ayurveda, which still informs Ayurvedic practice in India. The same work sorts operations into eight kinds, among them excision, scarification, puncturing, extraction and suturing, and its method of couching for cataract was known in China by the 7th century.

Its date is disputed. Tradition places its author, Sushruta, in the city of Kashi around 600 BCE, and a 2024 review in a plastic surgery journal still uses that date. The University of Alberta's Sushruta Project, which is editing the oldest manuscripts, describes the work as a picture of South Asian medicine about 2,000 years ago, comparable in age to the Hippocratic Corpus and the Yellow Emperor's Inner Classic. The oldest surviving copy, a palm-leaf manuscript in the Kaiser Library in Kathmandu announced in 2007, dates from 878 CE, almost a thousand years earlier than any other known manuscript.

The Project's editors also note that the five verses on the nose are written in a different metre from the rest of their chapter and come at its very end, which could mean they were added later. Travelers saw Indian practitioners rebuilding noses from the 17th century on. In 1793 two surgeons at the British hospital in Poona, James Findlay and Thomas Cruso, watched the operation on Cowasjee, a bullock driver for the British army whose nose had been cut off after Tipu Sultan took him prisoner, and a letter describing it appeared in The Gentleman's Magazine in London in October 1794. That operation took the skin from the forehead, not the cheek.