Sushruta, a trailblazing surgeon from 600 BCE ancient India, remains most renowned for the Indian-Method Rhinoplasty (IMR). His historic technique for nasal reconstruction centred on local rotational flap advancement; principles that were millennia ahead of their time. Nose amputation was a common form of punishment in ancient India for crimes such as adultery, theft, or social misconduct. This practice publicly shamed and stigmatized offenders. The frequency of these punitive punishments necessitated reconstructive procedures, heralded by Sushruta. Intricate documentation of IMR has been passed through familial generations in India, spreading through Persia, Italy and to colonial-era Britain. This historic and pioneering act has been preserved in the modern surgical setting. Sushruta starts his IMR with a leaf or creeper to match the dimensions of the patient’s defect. This template is used to map out donor forehead tissue. The local flap is raised cauda-cranially. This flap, attached by a pedicled vascular supply, is rotated into the severed nose. The wound was covered with cotton and pure sesame seeds. This practise of tissue transfer is dependent on thorough understanding of tissue viability, fundamentals of vascular supply and anatomical relations of surrounding structures. IMR served as a forerunner in the field of local flaps, whereby advancement, rotation or translation of donor tissue allowed inset into existing defects. Sushruta’s groundbreaking principles influenced our current understandings and capabilities of tissue reconstruction. This poster honours a crucial historical figure in surgery, inspiring contemporary reconstructive procedures. whose legacy continues to shape the future of rhinoplasty.