{"id":39484,"date":"2017-07-20T10:57:39","date_gmt":"2017-07-20T09:57:39","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmj\/?p=39484"},"modified":"2017-07-20T10:57:39","modified_gmt":"2017-07-20T09:57:39","slug":"jeave-reserva-at-al-soft-tissue-fillers-in-aesthetic-medicine","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2017\/07\/20\/jeave-reserva-at-al-soft-tissue-fillers-in-aesthetic-medicine\/","title":{"rendered":"Jeave Reserva at al: Soft tissue fillers in aesthetic medicine"},"content":{"rendered":"

Soft-tissue fillers have become a cornerstone of modern nonsurgical aesthetic medicine, but they have come on a long way since the use of paraffin as a filler in nineteenth century aesthetic medicine.<\/p>\n

A dry distillation by-product of beech-wood tar paraffin was discovered in 1830 by German chemist Baron Karl Ludwig von Reichenbach, who noted its minimal reactivity (<\/span>parum affinitas<\/span><\/i>) to acids or alkalis. In 1899, Austrian surgeon Robert Gersuny\u2019s successful use of injected paraffin as a testicular prosthesis in a castrated patient raised the profile of this first filler as a material for aesthetic non-surgical augmentation.<\/span><\/p>\n

In this pre-penicillin era, however, it was the stigma of the saddle nose of congenital syphilis that created an astonishing demand for paraffin\u2019s use in nasal augmentation. [3] A horrifying sequela resulting in part from paraffin migration along adipose tissue, granulomatous foreign body reactions known as paraffinomas soon became evident in patients who had undergone paraffin injections. [1,2] For Gladys Spencer-Churchill, the second wife of the 9th Duke of Marlborough, these yellowish firm skin nodules became so disfiguring that she banned all mirrors in her residence. Despite being considered a stunning beauty, she had become obsessed with a small protrusion on her nasal dorsum and underwent paraffin nasal bridge augmentation in 1935, hoping to attain the highly sought-after Grecian profile. [3] She later developed multiple facial paraffinomas that led her to isolate herself and die as a recluse in 1977. [2,3]<\/span><\/p>\n

Similarly, some of those treated with paraffin injections for saddle noses resulting from congenital syphilis developed diffuse facial paraffinomas, which mimic yet another stigmatizing facial deformity<\/span>\u2014<\/span>the leonine faces of leprosy. [3]<\/span><\/p>\n

Although reports of patients self-treating with paraffin-related or other fillers still exist, aesthetic non-surgical facial augmentation has progressed such that we now have the means to more safely meet patients’ expectations. [2,3,4,6]<\/span><\/p>\n

\u00a0\"\"<\/a><\/em>Jeave Reserva<\/strong> is a dermatology clinical research fellow at the Loyola University Medical Center, Illinois, US<\/p>\n

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\"\"Monica Janeczek<\/strong>\u00a0is a second year medical student at the Stritch School of Medicine, Loyola University Medical Center, Illinois, US<\/p>\n

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\"\"James Swan<\/strong>\u00a0is director of the patch testing program and professor of dermatology at the Loyola University Medical Center, Illinois, US<\/p>\n

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\"\"<\/em>Rebecca C. Tung<\/strong>\u00a0is director of the division of dermatology and clinical associate professor of dermatology at the Loyola University Medical Center, Illinois, US<\/p>\n

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Competing interests: <\/em><\/strong>none declared<\/em><\/p>\n

\u00a0<\/strong><\/p>\n

References<\/strong><\/p>\n

    \n
  1. Haiken E. Plastic surgery before and after. In: Venus envy. <\/em>Baltimore, Maryland: The Johns Hopkins University Press; 1997:19-23.<\/li>\n
  2. Kontis TC, Rivkin A. The history of injectable facial fillers. Facial Plast Surg<\/em>. 2009;25(2):67-72.<\/li>\n
  3. Glicenstein J. [The first “fillers”, vaseline and paraffin. from miracle to disaster]. Ann Chir Plast Esthet<\/em>. 2007;52(2):157-161.<\/li>\n
  4. De Gado F, Mazzocchi M, Chiummariello S, Gagliardi DN, Alfano C. Johnson’s baby oil, a new type of filler ? Acta Chir Plast<\/em>. 2006;48(4):123-126.<\/li>\n
  5. Park TH, Seo SW, Kim JK, Chang CH. Clinical outcome in a series of 173 cases of foreign body granuloma: Improved outcomes with a novel surgical technique. J Plast Reconstr Aesthet Surg<\/em>. 2012;65(1):29-34.<\/li>\n
  6. Goisis M, Petrillo A, Rinna C, Brillante C, Guareschi M, Youssef D. Fillers in aesthetic medicine. In: Goisis M, ed. Aesthetic medicine. <\/em>Milan: Springer; 2014:3-24.<\/li>\n<\/ol>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Soft-tissue fillers have become a cornerstone of modern nonsurgical aesthetic medicine, but they have come on a long way since the use of paraffin as a filler in nineteenth century aesthetic medicine. A dry distillation by-product of beech-wood tar paraffin was discovered in 1830 by German chemist Baron Karl Ludwig von Reichenbach, who noted its […]<\/p>\n

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