According to the statistics of 2021, there was a 19.3% overall increase in procedures performed by plastic surgeons with more than 12.8 million surgical, and 17.5 million non-surgical, procedures performed worldwide. But do you know about the roots of plastic surgery more particularly rhinoplasty and where it was first performed?

The Origin of Rhinoplasty

During the third Anglo-Mysore war in 1792 between the East India Company and Tipu Sultan of Mysore, Cowasjee, a bullock-cart driver and four other British soldiers were taken prisoners by the Sultan at Seringapatam, Karnataka. Mutilation of body parts was a punishment frequently awarded by the rulers for crimes ranging from theft, arson, adultery, murder, or those against the State. As a punishment for being a traitor, their noses were cut off as a mark of humiliation. For nearly a year, these soldiers went without a nose until Sir Charles Malet, a British minister in the Peshwa court at Poona, came across an oilcloth merchant with a feeble scar on his nose.

The merchant explained that his nose had been amputated as a punishment for adultery and was later rebuilt by a Poona potter using his forehead skin. Thereafter the potter recommended by the oil-cloth merchant to reconstruct the noses of Cowasjee and the other four soldiers was summoned. The potter explained that such nasikasadhana art had been practised in complete secrecy and passed down from generation to generation within a single family by referring to the first principles of plastic surgery which were articulated by Sushruta (known as the Father of Plastic Surgery). In his treatise Sushruta Samhita in 600 BCE, Sushruta described over 300 surgical procedures and about 120 surgical instruments all of which were his own inventions.

Cowasjee’s nasal reconstruction by the potter was witnessed by Mr. Thomas Crusoe and Mr. James Findlay, two British physicians from the Bombay Presidency. Ten months later, Cowasjee’s portrait depicting the successful surgery was painted ten months later, in January 1794, by the British painter James Wales. In January 1795, the surgical procedure was published as “A Singular Operation,” and Cowasjee’s portrait appeared alongside the article.

 *We do not claim any copyright in the above image. The same has been reproduced for academic and representational purposes only”.

Cowasjee’s nasal reconstruction procedure which was practised for generations in India became popular as the “Indian Nose” among the surgical circles all over the world, and brought recognition to India as the birthplace of plastic surgery.

The case is significant because it is one of the rarest in medical history where the patient was popularised more than the surgeon. The British attempted to prove to the world that they took good care of their soldiers and concealed the name of the surgeon-potter, except the fact that he stayed at a location about 400 miles from Pune ensuring that India did not get its due recognition. Despite several modifications since then, the procedure is still the best method of nose reconstruction and laid the foundations of the present-day rhinoplasty.