History of plastic surgery in India

The earliest replantations were done by Lord Shiva by attaching an elephant’s head on his son’s body 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 Divadaasa of Banaras (Lord Dhanvantri). Sushruta, who was Vishwamitra’s son, along with others approached Dhanvantri and requested him to accept them as his “shishyas” and teach them the science of Ayurveda.

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. It is said that Sushruta taught surgery at the Banaras University.[2]He has very succinctly described the reconstruction of the nose by cheek flap, repair of cut earlobe, piercing of earlobe, repair of cut lip, skin grafting, classification of burns, wound care and wound healing. Sushruta has been rightly called the “Father of Plastic Surgery” and “Hippocrates” of the 6th or 7th century BC. He described rhinoplasty for a cut nose as follows:[1],[2]
1) The leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be gathered,
2) A patch of living flesh, equal in dimension to the preceding leaf should be sliced off from the region of the cheek.
3) After scarifying the severed nose with a knife, the flesh is swiftly adhered to it.
4) Insert two small pipes in the nostrils to facilitate respiration and to prevent flesh from hanging down.
5) The adhesioned part is dusted with the powders of Pattanga, Yashtimadhukam and Rasanjana pulverized
together.
6) The nose should be enveloped in Karpasa cotton and several times sprinkled over with the refined oil of pure sesamum.
7) When the healing is complete and parts have united, remove the excess skin.”
Even in those days he had emphasised the accurate cutting of the pattern to the size of the defect, the accurate cutting and suturing of the flap to the nose and maintaince of airway with tubes.
Frank McDowell has very aptly described Sushruta in the book “The source book of plastic surgery”[2] as follows: 
Through all of Sushruta’s flowery language, incantations and irrelevancies, there shines the unmistakable picture of a great surgeon. Undaunted by his failures, unimpressed by his successes, he sought the truth unceasingly and passed it on to those who followed. He attacked disease and deformity definitively, with reasoned and logical methods. When the path did not exist, he made one.”
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 Vaghbat wrote Ashtanga Sangraha and Ashtanga Hridyans. In Ashtanga Hridyans, he described rhinoplasty as done 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 Vaghbat was later modified by using a rotation flap from the adjacent forehead, The Traditional Indian Method of Rhinoplasty. This was kept a secret for centuries in India, and practiced by Marattas of Kumar near Poona, certain Nepaly families and Kanghairas of Kangra (Himachal Pradesh).

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Dr. S. C. Almast personally met the last Hakim of Kangra, Mr. Dinanath Kanghaira whose family was practicing the art of rhinoplasty since the war of Kurukshetra and at Kangra since 1440 AD. Those with cut noses and deformed noses due to leprosy and syphilis were operated by them. 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 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.
Although Britishers lived in India for a long time, they were not aware of Indian Rhinoplasty till 1793. Mr. James Findlay and Mr. Thomas Crusoe who were surgeons at the British Residency in Poona in 1793 witnessed the operation on “Cowasjee” and reported the details of the operation in the Madras Gazette. The same operation on Cowasjee was later published in Gentleman’s magazine, London, Oct. 1794 by a letter from Mr. Lucas as follows: “Cowasjee, a Mahratta of the caste of the husbandmen, he was a bullock driver with the English Army in the war of 1792, and was made prisoner by Tipu Sultan, who cut off his nose and one of his hands. He joined the Bombay Army near Seringapatam. For about 1 year he remained without a nose, when he had a new one put on by a man of the Brickmaker (potter’s) caste near Poona”.
Towards the end of the 19th century, two important works were published in India. One was titled “Rhinoplasty” by Tribhovandas Motichand Shah in 1889, who was then the Chief Medical Officer of Junagadh. He described over a hundred cases treated by him in 4 years and gave minute operative details and discussed the advantages of forehead rhinoplasty. He used paper to make a pattern and used anesthesia. (Till now there was no mention of anaesthesia. Patients were just given wine to drink before surgery.) His name became a legend and it was said that “Kalu cuts the nose and Tribhovan reconstructs it”. Kalu was a local dacoit of that time who used to cut off people’s noses. The other book was “Rhinoplasty operations, with a description of recent improvements in the Indian method” by Keegan in 1900. 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 Sushruta remain the same.

Plastic Surgery in modem India owes a great deal to Sir Harold Gillies, Eric Peet and B.K. Rank for developing this speciality. In 1945, two Indian maxillofacial surgical units were established. No.l unit at Kirkee under Fitzgibbon and later under Gibson. No. 2 unit was at Secunderabad under Eric Peet. In 1946, Dr. C. Balakrishnan was posted at the No. 1 unit. The two units later merged to form a maxillofacial center for the Indian Army at Bangalore.
In 1950, the first two Plastic Surgery departments were established in India. One at Patna under Dr. R. N. Sinha and the other at Nagpur under Dr. C. Balakrishnan. Sir Harold Gillies paid a visit to India and he was pleased with the work being done by Indian surgeons, especially Major Sukh, at the Armed Forces Medical College, Pune.
In 1955, the Govt. of India invited Mr. B. K. Rank, from Australia, to advise on the development of Plastic Surgery in India. He welcomed the idea of forming a plastic surgery section of Association of Surgeons of India. In 1957 Sir Harold Gillies visited India again. During his visit to Pune, he demonstrated various operations and techniques. He visited and lectured at several centres in various parts of the country, namely, Calcutta, Delhi, Patna, Jaipur and lastly Nagpur where he formally inaugurated the Plastic Surgery section of Association of Surgeons of India. The members were Dr. R. N. Cooper, Dr. C. Balakrishnan, Dr. M. Mukerjee, Dr. R. N. Sharma, Dr. N. H. Antia, and Dr. Hiveda.The late Dr. C. Balkrishnan, was a devoted and dynamic plastic surgeon. He succeeded in establishing the first Department of Plastic and Maxillofacial surgery at the Govt. Medical College and Hospital, Nagpur. M. S. degree in Plastic Surgery was started in 1960, for the first time in India. Dr. Balkrishnan described Z-plasty for the nasal lining in cleft palate, classification of cleft lip and palate called as the “Nagpur Classification” and skin grafting in total avulsion of testes. In the same year, another department of Plastic Surgery was established at Patna under Dr. R. N. Sinha. Later, two more departments were started at Calcutta under Dr. M. Mukerjee and at Lucknow under Dr. R. N. Sharma.
Dr. Antia, the 3rd generation trained Plastic Surgeon under Sir Harold Gillies worked at theLeprosy home in Khandala (near Pune) in 1958. He was the first surgeon to succeed in the integration of leprosy in general hospital practice. The unit at Sir. J. J. Hospital, Mumbai, was started in 1959 under Dr. N. H. Antia. In 1964, Tata Trusts provided a substantial grant to carry out two projects – one on Leprosy and other on Burns. The world’s first microvascular surgery on humans, a free flap transfer using microvascular anastomosis was done in 1966 by Dr. Antia and Dr. Buch (Scandinavian journal of Plastic surgery 1977).
In 1961, another plastic surgery unit in Mumbai was established at K. E. M. Hospital, under Dr. Charles Pinto. Eric Peet from Oxford was a regular visitor to this department for the first 3 months. Dr. Pinto advocated one stage repair of cleft lip and palate, called as the “Hole-in-one” procedure. In 1964 one more department was started in Mumbai at G. T. Hospital, under Dr. R. J. Manekshaw.
In 1963, Safdarjung Hospital, Delhi started a department of Burns, Plastic and maxillofacial surgery, with Dr. J. L. Gupta, as its head. Gradually, multiple centers in Plastic Surgery were established all over the country and various associations were formed.
In 1971, Burns Association of India was formed during the 1st Congress of Burns at the J. J. Hospital. Dr. M. H. Keswani was the Secretary. Later under his leadership, the Burns Association flourished with contributions like potato peel dressings, prevention campaigns by way of radio and TV talks, small documentary ads, etc. “Pour water on Bums” has received worldwide popularity.
In 1974, Indian society of surgery of the hand was formed with Dr. Ashok Sen Gupta as the president. A hand surgery unit was started at the Stanley Medical College at Madras under Dr. R. Venkataswami. Today it is one of the biggest and best hand surgery units in the world. Indian Society for Reconstructive Microsurgery was also formed at Madras in 1992 with Dr. R. Venkataswamy as the president.
The contributions made by various Plastic Surgeons in India are numerous by way of devising new instruments, research and publications (papers and books). To mention all is beyond the scope of this paper. Today every state in India has multiple plastic surgery training centres. Each centre trains a number of postgraduate students every year who have spread all over India and abroad serving the community to their fullest. The specialty continues to grow and advance in all the fields of Plastic Surgery.

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The History of Plastic Surgery Goes Back to Ancient Times

The advancements of plastic surgery are phenomenal, but plastic surgery isn’t new. The history of plastic surgery goes back hundreds of years. Supposedly the first plastic surgeon was an Indian man title Susrutha who started the history of plastic surgery along with skin grafts. This surgeon resided in the 8th century, and the history of cosmetic surgery contends that he did nose and hearing surgery to improve the appearance of people afflicted with unbecoming functions. There is a written history of plastic surgery continuing into the 18th century. The Romans continued the history of plastic surgery with ear surgery as well.

There is written proof of the history of plastic surgery in Europe as soon as the sixteen 100s. The procedures noted likewise incorporate nose surgery. The history of plastic surgery does not become common until the 19th century. Plastic surgery was limited until the invention associated with anesthesia. With the procedures for anesthesia came the possibilities of more extensive plastic surgery methods. According to the history of cosmetic surgery, the first procedures were completed in America in early 19th century. The procedures of plastic surgery became more prevalent with the injuries experienced during the first world war.

The History associated with Plastic Surgery Includes Rebuilding Surgery

As healthcare techniques improved, the strategy of plastic surgery did as well. During the second world war, there were many surgeries done to repair damage to army people injured during the battles. Important improvement in the history of plastic surgery led to help for people looking for reconstructive surgery. These individuals included those with cleft palates and those who lost their bosoms because of cancer treatments. The plastic surgeons began to do more for people damaged with serious burns. The surgical procedures continued to improve as did the actual procedures for administering aesthesia to patients undergoing a surgical procedure.

In the last the main twentieth century and at the start of twenty first century, the number of people utilizing plastic surgery increased substantially. Many people turned to plastic surgery for many different methods. Many people employed the services of plastic surgeons to remove fat from their bodies, in order to redesign their facial features and increase their breasts. Millions of dollars have been spent on plastic surgery in recent years. The methods are popular with both men and women. Plastic surgery is well-liked in the United States and in many different countries around the world.

Breast Implant History

Breast implant (breast augmentation) is one of the most commonly performed cosmetic surgery procedures in both the UK and USA. This statement is supported by the fact that according to the American Society of Plastic Surgeons there were approximately 329,000 breast implant procedures performed in the United States alone in 2006 and the figures seem to be continuously rising.

Breast Implants have been known to be used since 1895 to enlarge the size and shape of women’s breasts. The timeline below gives a brief overview of the history of breast enlargement and the various types of breast implants which have been attempted:

Breast Augmentation Timeline

1895-1920’s: earliest breast augmentation procedures were attempted. Paraffin injections were used to enlarge the breast size. This procedure was eventually discarded due to high rates of infection and other complications.

1920’s- 1940’s: breast implants were attempted using fatty tissue extracted from the belly and buttock areas. This breast augmentation procedure was eventually also discarded in the 1940’s as the body would quickly reabsorb most of the fat leaving the breasts looking asymmetrical and lumpy.

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1950’s: during this period breast augmentation was attempted by using polyvinyl sponges as breast implants. Other types of synthetic sponges where also attempted but all were found to shrink and harden after about one year. Alongside this, infection rates were also noted to be high with this type of breast implant and eventually the procedure was stopped.

1961: the first silicone breast implant was developed by Thomas Cronin and Franks Gerow who were two plastic surgeons based in Houston, Texas. This breast implant is now known as the Cronin-Gerow implant or first generation silicone breast implant.

1962: the first silicon breast implant surgery was attempted. Over time silicone breast implants have been continually enhanced and now we are using 4th and 5th generation silicone implants for breast augmentation.

1964: Saline filled breast implants were first produced in France in 1964. Saline breast implants became particularly popular in the United States in the 1990’s with the restrictions which were placed on silicone breast implants at the time.

1964-2007: since the manufacturing of the original saline and silicone breast implants; continuous refinement has taken place to make both types of breast implants safer and reliable. Many comprehensive studies have taken place since the early 1990’s to assess if there is a link between silicone breast implants and systemic diseases. The consensus of these studies is that there is no clear link between silicone breast implants and systemic diseases, including breast cancer, rheumatic disorders or any auto immune condition. Millions of women throughout the world now continue to enjoy the benefits of having successful breast augmentations.

The Hurlingham Clinic is one of the leading breast surgery clinics in London specialising in Breast Lift, Breast Uplift and other forms of cosmetic surgery. If you are considering having breast augmentation then please contact us on 020 7348 6380 to arrange a consultation with one of our fully qualified and experienced cosmetic surgeons who will be more than happy to discuss your individual requirements with you in depth.

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History of Face Lift Plastic Surgery

Few forms of plastic surgery are as ubiquitous today as the face lift, and why not? No other procedure gives people the chance to completely turn back the clock when it comes to their aging features. Women in their 50s and above can look ten or twenty years younger with the help of a surgeon’s guiding hand. In a culture as youth obsessed as ours, there is no wonder why the operation is so popular. Of course, the procedure is really nothing new. Here we take a look at the history of this amazing medical development.

Over 100 years ago, the first cosmetic face lift was performed. Of course, the procedure in those days was quite a bit simpler than those being done on the Hollywood stars of today. The surgeon would cut away a bit of the flesh from the patient’s scalp and then pull the remaining skin up and over the gap. The facial features were pulled taut and the desired look was achieved. Of course, anyone who left the surgeon’s office with those results today would sue for malpractice. After only a few months, the scar would begin to stretch and even the minimal effects that had been achieved would be lost as the skin started to drag down again.

To improve on the operation, doctors began lifting the front edge when they made the initial incision in a patient’s forehead. Doing this, it would change the way the patient healed from the surgery as well as making it easier to manipulate the skin during surgery. The skin would reattach in the same way, except it would be doing so at a higher point than it had been previously, thus eliminating the eventual dragging that ruined the earlier forms of the operation. During this time it was also realized that surgeons needed to pull the skin completely away from the underlying tissues to achieve a more permanent and impressive result.

Today, the procedure known as the face lift is more technologically advanced than ever before, and a good surgeon can get results that can only be termed miraculous. Some people; prior to having work done, wonder how long the effects will last. The question is not an easy one to answer. A person who has had the surgery will continue to experience the effects of aging after the process. But they will have an extra ten years (appearance-wise) that they didn’t have before. So someone who had the surgery at 50 may look 40 after the operation, and 50 when they are 60. Of course, results will vary from person to person.

As always, if an individuals chooses to undergo the face lift procedure, they should do their research beforehand to make sure it is the right thing for them. Being prepared and having the rights questions is a fail-safe way to ensure the best results from any type of surgery.

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