It is generally accepted that the first recorded plastic surgery performed was for the nose in India as found in ancient Sanskrit texts around 600 B.C. Noses were lost then as a form of punishment (ears were also) for crimes or in battle. From the text Sushruta Samhita, the Hindu surgeon Sushruta describes transferring skin from the cheeks or forehead to make a new nose. What was unique about this skin transfer is that a portion of it was left attached from where it came, known today as a flap technique. It was then partially twisted on itself and then sewn into place. The skin flap was placed on top of two wooden tubes that were placed in the nostrils to keep the nasal airway open as it healed. This method of nose reconstruction became known as the Indian Method of Rhinoplasty. It was the harbinger of the forehead flap which is still the best method for nasal reconstruction today for loss of significant parts of the nose due to cancer and traumatic injury. While a far cry from what is commonly perceived as a rhinoplasty, like most of aesthetic plastic surgery today, the origins of cosmetic changes are rooted in a long prior history of reconstructive experiences.