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Background: Sushruta is widely regarded as a pioneer of plastic surgery because the Sushruta Samhita describes reconstruction of the nose using a pedicled cheek flap and repair of the ear lobe by numerous techniques. The “Indian method” of nasal reconstruction, using a forehead flap, became known in Europe in 1794 and inspired modern nasal reconstruction. Objective: To review Sushruta’s descriptions of nasal and ear lobe reconstruction, trace the transmission of the Indian method to Europe, and compare these techniques with modern nasal reconstruction. Methods: Historical review of Sushruta Samhita and of literature on the history of plastic surgery and nasal reconstruction. Results: Sushruta describes measuring the defect with a leaf template, raising a flap of skin from the cheek while keeping it attached, rotating it to cover the nose, inserting tubes into the nostrils and dressing the wound, with attention to haemostasis and post-operative care. He also describes 15 methods of repairing the torn ear lobe. Later Indian practitioners used a forehead flap for nasal reconstruction, a procedure reported in a British magazine in 1794 and adopted in Europe by surgeons such as Carpue. The modern paramedian forehead flap, now a standard method for nasal reconstruction, is a direct descendant of this tradition. Conclusion: Sushruta’s reconstructive principles, including templates, pedicled flaps, preservation of blood supply and careful aftercare, remain fundamental to plastic surgery. The Indian method of rhinoplasty is one of the clearest examples of the influence of Ayurvedic surgery on modern medicine.

KEYWORDS: Sushruta; rhinoplasty; nasal reconstruction; forehead flap; pedicled flap; plastic surgery history; ear lobe repair; Sandhana Karma