[The first "fillers", vaseline and paraffin. From miracle to disaster]

Abstract

In 1899, Robert Gersuny, an austrian surgeon from Vienna, injected a mineral oil (vaseline) to correct the absence of a testicle in a patient who was castrated for tuberculous epididymitis. The immediate success of the operation encouraged him to use vaseline as filler for soft tissue defects. The principle of the technique consisted in the injection of a product that becomes semi liquid by heating but it solidifies when it gets colder. It remains stable and inert in the human body. Eckstein used paraffin instead because the melting temperature is too high (65 degrees ) to soften after the injection. The technique provoked enthusiasm. It was used for the cure of palatal and urinary fistulae, hernia but mainly in cosmetic indications: filling of face wrinkles, cheeks, front and breast augmentation as well as the penis and especially nasal defects. Although serious complications were reported, it remained popular for the first 20 years of the 20th century. Unfortunately even with initial good results, secondary or late severe complications appeared due to the dispersion of paraffin. There was formation of nodules, the paraffinomas that were very difficult to remove. The sequelae of paraffin injections were observed for several years.