The History of Rhinoplasty ⑤ — Saddle nose, and the implant that began as concealment

Syphilis, first reported in Europe in 1495, shook society for centuries afterwards.

When the disease reaches its tertiary stage the bone and cartilage of the bridge collapse and sink; this is called a saddle nose.

The trouble is that it did not end at a change in appearance. A collapsed bridge was read at once as a sign that this person had syphilis.

People whose noses had fallen in for entirely different reasons met the same gaze.

Eighteenth-century London even left behind satirical accounts of a “No-nose Club” where people who had lost their noses were said to gather.

So the people of this period threw themselves into hiding the nose.

Artificial noses made of silver or other metal were worn on the face.

A silver prosthetic nose used by a woman who lost hers to syphilis in the mid-nineteenth century survives to this day.

Then, around 1900, the Viennese physician Gersuny began injecting melted paraffin beneath the skin to fill a sunken bridge.

The records of the time report thirty cases performed without incident, and the method spread quickly through Europe and America.

The outcome was not good. Warnings appear in the papers of the period already.

If the melting point of the paraffin was below body temperature it travelled along the lymphatics, and if it was too hard it caused tissue necrosis.

There are reported cases where injected paraffin flowed into the eyelid and could not be retrieved. Once paraffinoma — the lumps and inflammation paraffin forms inside the body — became known, the method was abandoned.

I come back to this passage often. The idea of putting something into the nose is well over a hundred years old, but most of that century was spent learning what must not be put in.

That we can use comparatively safe materials now is because someone paid that price first. This, I think, is why one has to be careful in choosing a material.