History of plastic surgery in India

1. History of Plastic surgery in India
Dr Joe Antony

2. Plastic surgery
• Plastikos
– Greek word
– To mold
• Some scholars consider plastic surgery among
things Indian ancient cultures donated to
world like calculus, numericals, zero, botanical
classification

3. Vedic times- 4000BC
• Lord Shiva attached an elephant’s head on
his son’s body
• Ashwini Kumars successfully replanted the
severed head of Yagna

4. Sushrutha
• Father of Indian plastic surgery
• Hippocrates of 6th century BC
• Son of Vishwamitra
• Major shishya of Dhanvanthari, who was one
of first ayurvedic practioner

5. Shusrutha Samhita
• Part of Atharva veda
• Compiled by shusrutha, from ayurvedic
knowledge passed down by Dhanvanthari and his
own practice
– 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,Different type of
dressings
• Original text is lost. present extant one is believed
to be a revision by the Buddhist scholar
Vasubandhu (circa AD 360-350)

7. Other Rhinoplasties in Ancient India
• Second method of rhinoplasty in India as
practiced by Tilemakers.
– using a free graft from the gluteal region
• 4th century,Vaghbat wrote Ashtanga Sangraha
– inner lining by turning down the nasal skin
• Traditional forehead flap rhinoplasty
– Marattas of Kumar near Poona, certain Nepaly
families and Kanghairas of Kangra

8. • rhinoplasty spread from India to Arabia and
Persia and from there to Egypt and Italy in the
15th century.
• Translation of sushrutha samhitha
– Latin by Hessler in 1844
– Arabic by Ibn Abi Usaybia (1203-1269 AD) and
later into German by Vellurs.
– Bhishagratna translated it in English in 1907

9. Cowasjee and Gentleman’s magazine
• in 1793 ,Mr. James Findlay and Mr. Thomas
Crusoe witnessed the operation on
“Cowasjee” and reported the details of the
operation in the Madras Gazette.
• Cowasjee case was later published in
Gentleman’s magazine, London, Oct. 1794

10. 19th Century
• “Rhinoplasty” by Tribhovandas Motichand Shah
in 1889
– minute operative details
– discussed the advantages of forehead rhinoplasty
– Paper to make a pattern
– used anesthesia
• “Rhinoplasty operations, with a description of
recent improvements in the Indian method” by
Keegan in 1900

11. First maxilofacial surgery units
• 1945
– No.l unit at Kirkee under Fitzgibbon and later
under Gibson
– No. 2 unit was at Secunderabad under Eric Peet
• Dr C Balakrishnan was posted in Unit1 in 1946
• Later both merged to form a maxillofacial
center for the Indian Army at Bangalore

12. First plastic surgery units
• 1950
– at Patna under Dr. R. N. Sinha
– at Nagpur under Dr. C. Balakrishnan
• Sir Harold Gillies was pleased with the work
being done by Indian surgeons, especially
Major Sukh, at AFMC, Pune.

13. • 1955,
– BK Rank visited India and floated idea of an
association for plastic surgeons
• 1957
– Sir Harold Gillies agian visited India
– Demonstrated and lectured various
surgeries and techniques, especially
tube pedicled flaps

14. Plastic Surgery section of Association
of Surgeons of India
• Inaugurated by Harold Gillies in 1957
• Members were
– Dr. R. N. Cooper
– Dr. C. Balakrishnan
– Dr. M. Mukerjee
– Dr. R. N. Sharma
– Dr. N. H. Antia
– Dr. Hiveda

15. Dr. C. Balkrishnan
• 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.
• Described Z-plasty for the nasal lining in cleft
palate
• Classification of cleft lip and palate called as the
“Nagpur Classification”
• Skin grafting in total avulsion of testes.

16. First plastic surgery departments
• Dr. C. Balkrishnan - Govt. Medical College and
Hospital, Nagpur
• Dr. R. N. Sinha - Patna
• Dr. M. Mukerjee – Calcutta
• Dr. R. N. Sharma - Lucknow

17. Dr. Antia
• worked at the Leprosy home in Khandala (near
Pune) in 1958
• first surgeon to succeed in the integration of
leprosy in general hospital practice
• The unit at J. J. Hospital, Mumbai, was started in
1959
• 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

18. Dr. Charles Pinto
• In 1961, another plastic surgery unit in
Mumbai was established at K. E. M. Hospital
• One stage repair of cleft lip and palate, called
as the “Hole-in-one” procedure

19. Associations
• 1971, Burns Association of India was formed at the
J. J. Hospital
– potato peel dressings
– prevention campaigns by way of radio and TV talks, small
documentary ads, etc. “Pour water on Bums” has received
worldwide popularity.
• 1974, Indian society of surgery of the hand was formed
with Dr. Ashok Sen Gupta as the president
• 1992, Indian Society for Reconstructive Microsurgery
was also formed at Madras with Dr. R. Venkataswamy

20. • Today every state in India has multiple plastic
surgery training centres.
• Each centre trains a number of postgraduate
students every year
• The specialty continues to grow and advance
in all the fields of Plastic Surgery.

21. References
• Rana R E, Arora B S. History of plastic surgery
in India. J Postgrad Med 2002;48:76
• Principles and Advances in plastic surgery by
Karoon Agarwal, Volume 1