How did early Hindu surgeons reconstruct noses with skin flaps?

Ancient Indian surgeons, most notably Sushruta, pioneered plastic surgery techniques to reconstruct noses, a procedure often necessitated because amputation of the nose was a prescribed punishment for adultery.1

To perform this reconstruction, surgeons utilized a technique involving skin flaps. They would cut a piece of tissue of the required size and shape from the patient’s own cheek or forehead. This tissue was then applied to the stump of the nose to restore its form. These early procedures demonstrated a sophisticated understanding of tissue management, as the reconstructed tissue was bridged from adjacent areas to cover the defect. The results of these ancient operations were reportedly quite satisfactory, and modern rhinoplasty is considered to be indirectly derived from these foundational techniques.12