Abstract
Background: "Sandhana Karma" as described in Ayurveda is an ancient surgical procedure that can be likened to the plastic surgery or reconstructive surgery of the present day. Plastic surgery is one of the key subspecialties within the field of surgery.
Objective: This review provides a critical analysis of the concept, principles, and techniques of Sandhana Karma, and compares it with the modern era's plastic and reconstructive surgery.
Materials and methods: The study reviewed classical references from Sushruta Samhita and contemporary literature on plastic surgery, as well as findings from recent research articles. The article highlights the comparison of the basic principles and select procedures of plastic surgeries in the Sushruta Samhita and modern sciences. It examines the correlation between Sandhana Karma and the present era of plastic and reconstructive surgery.
Observations: Key principles of Sandhana Karma include preservation of vital structures, restoration of form and function, atraumatic technique, proper wound management, and a holistic approach. These principles align with modern surgical practice. The review highlights specific techniques described in the Sushruta Samhita, such as forehead flaps for rhinoplasty and various methods for ear and lip reconstruction, and compares them with contemporary techniques like endonasal rhinoplasty, cartilage grafts, local and distant flaps, lip sharing procedures, and vermilion advancement.
Conclusion: Modern plastic surgery owes a debt of gratitude to Acharya Sushruta, who is considered a pioneer of plastic surgery. From the fundamental principles of plastic surgery to some complex procedures practiced today, they have direct origins in the Sushruta Samhita.

Key words: Sandhana Karma, Plastic Surgery, Rhinoplasty Auroplasty, Lipoplasty.