Actually the earliest record of autogenous pedicle grafts, used to restore mutila tions of the nose, ear and lip were found in the Sanskrit of India, the Sushruta Samhita, dated circa A.D. 450, which dates back several centuries before the Christian era. Sushruta described the techniques of rhinoplasty and other plastic procedures in his work which appeared to have evolved in response to the social pressures encountered by the stigmata left by mutilations carried out in punishment for crimes committed.