Nasal reconstruction represents one of the earliest and most influential developments in reconstructive surgery, with techniques evolving over millennia to address trauma, punishment-related mutilation, and disease. The earliest systematic descriptions originate from ancient India, where the Sushruta Samhita (circa 600 BCE) detailed nasal reconstruction using a pedicled cheek or forehead flap, a technique now recognised as the foundation of the Indian method of rhinoplasty (Sushruta; Bhishagratna 1907). This approach emphasised robust vascular supply and remains the conceptual basis of the modern paramedian forehead flap. During the Renaissance, nasal reconstruction was independently refined in Europe through the Italian method. Gaspare Tagliacozzi of Bologna described staged nasal reconstruction using a pedicled upper arm flap in his seminal work De Curtorum Chirurgia per Insitionem (1597), establishing principles of tissue transfer, surgical planning, and postoperative care that shaped early plastic surgery (Tagliacozzi 1597; Mazzola & Mazzola 1996). Although technically demanding, the Italian method represented a major conceptual advance in reconstructive thought. Modern nasal reconstruction advanced rapidly in the 20th century, particularly following the World Wars, when Harold Gillies and later Ralph Millard refined reconstructive principles and flap design (Gillies & Millard 1957). Contemporary practice has been further shaped by Burget and Menick, who introduced the aesthetic subunit principle, emphasising anatomical precision and staged reconstruction to optimise both form and function (Burget & Menick 1985; Menick 2002). The significance of nasal reconstruction lies in its role as a cornerstone of plastic surgery, integrating anatomy, aesthetics, and vascularised tissue transfer. Its historical evolution continues to inform modern reconstructive strategies, underscoring enduring principles that remain central to contemporary practice.