Background: Nasal reconstruction's roots trace back to the Sushruta Samhita compendium (1000–800 BC). The transmission of these techniques to medieval Italy, notably through the Branca family's "Italian method" in the fifteenth century, poses a historical mystery. Methods: A comprehensive review of medical and historical databases explored the transmission of nasal reconstruction techniques from ancient India to Italy. The study investigated the Great Translation Movement, Arab influences, and potential intermediaries. Theories, including the Arab conquest of Sicily and Constantine the African's role, were scrutinised for insight into the pathways of Indian rhinoplasty methods reaching Europe. Results: Contrary to von Graefe's suggestion of direct Arab involvement, the Great Translation Movement emerged as a significant link. Works by Rhazes and Avicenna referenced Sushruta, with proposed translations by Indian physicians like Manka or Ibn Abillsaibial. The Arab conquest of Sicily in 878 AD was considered a potential introduction point. Constantine the African, translating in Italy, may have played a role in bringing Indian rhinoplasty methods to Sicily. Conclusions: The question of how Gustavo Branca acquired Indian techniques persists. Speculation includes potential origins in Provence and travels to Persia before settling in Sicily. The study illuminates a complex historical narrative involving events, translations, and cultural exchanges. This narrative culminated in the dissemination of Indian rhinoplasty methods in Italy, significantly influencing the fifteenth-century groundbreaking work of the Branca family. The transformative chapter in nasal reconstruction history underscores the enduring impact of cultural exchanges across centuries.