Surgery often seems to be almost like magic these
days; you can get a new hip to save you pain, or a new heart to save
your life. You can have a bigger breasts or a smoother neck, although
these operations are carried out to save face rather than life; this
plastic surgery is far from new, as is explored on Channel 4 this week
(details).
In my forthcoming series – more next week – we
explore a little of this curious history. Apparently the Indians were
especially adept at rhinoplasty, or nose jobs. In the violent past,
noses were frequently cut off, either in battle or as a punishment for
criminals, and doctors worked out clever ways to rebuild them. About
600 BC a chap called Sushruta wrote a medical textbook, in a mixture
of prose and poetry, describing a wide range of surgical procedures,
but his speciality was nose reconstruction.
Sushruta took skin from the cheek to build up the
nose, but the skin graft remained a problem. Once the skin has been
removed from one part of the body it loses its blood supply, and there
is a danger that it will not ‘take’ in the new place, because it
cannot get the oxygen it needs, and new blood vessels cannot develop
quickly enough. Sushruta’s followers developed a cunning technique to
get around this. First they found a leaf that had roughly the same
shape and area as the nose they wanted to reconstruct. Then they laid
this upside down on the forehead, so that the point of the leaf was on
the bridge of the nose-to-be. They traced round the edge of the leaf,
and cut that skin away from the forehead, carefully leaving it
connected at the bridge of the nose. They twisted this flap of skin
round until it could sit over the nose, and then laid it carefully in
place, so that it covered the new nose but still had a supply of blood
through the small connection now at the top.
This was so successful that the same technique,
learned in India, was used for the first plastic surgery operation in
Britain on 23 October 1814, when an army officer had a nose job in
York Hospital, Chelsea, and believe it or not, it is still used today,
as I learned from the top-flight 21st-century plastic
surgeon who demonstrated on me…
