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 CHAPTER I HISTORICAL REVIEW THE DEVELOPMENT OF RHINOPLASTIC AND OTHER PLASTIC OPERATIONS

The history of plastic surgery is closely associated with the development of rhinoplastic operations, and nearly all of the procedures used have originally been employed in the process of this development. Many years before plastic surgery was attempted in Europe, certain members of the Tilemaker caste in India obtained wonderful results in plastic operations with pedunculated flaps from the cheek and later from the forehead, in the reconstruction of amputated noses. This is known as the Indian Method.

They are also said to have occasionally used successfully for the same purpose free flaps of skin taken from the gluteal region including the subcutaneous fat, after it had been beaten with wooden slippers until a considerable amount of swelling had taken place. They used a secret cement for the adhesion, to which was ascribed special healing power. This is called the Ancient Indian Method.

Here, then, is the earliest record of whole-thickness grafting, and antedates by centuries the work of Wolfe, Krause and others.

It is interesting to note that plastic surgery was practised in ancient India and Egypt, as is shown by the sacred writings of India, and in Ebers' Papyrus, in both of which rhinoplasty is mentioned as a well-known procedure.

Celsus speaks of the restoration of ears, noses and lips, with the aid of the neighboring skin, and Galen, Antyllus and Paul of Aegina also mention these operations.

Then for many years the art of plastic surgery seems to have been lost, at any rate to European surgeons.

In the middle of the fifteenth century, about 1442, Branca (or Brancas), a Sicilian surgeon, was able to build noses by taking pedunculated flaps from the skin of the face, and, following him, his son