The author was called to attend a case several hours after the operator had injected a nose. The acute symptoms pointed to a direct occlusion of the vessels, yet the surgeon who had performed the operation assured me he had not injected until he found that blood did not flow from the needle after its insertion. To relieve the patient of immediate fright and some pain, a dull pointed needle of larger caliber than the one used in operation was pushed through the needle wound previously made, taking the place of a cannula, and a greater part of the injected mass was squeezed out. Ice cloth applications were followed through the night and the nose recovered in three days without showing the discoloration of the skin usually observed following such cases. The nose was never injected again, on account of the dread of the patient, but peculiarly the anterior line showed almost a normal contour after four weeks had elapsed. This only goes to prove that very much less of the mass to be injected is required than is commonly supposed by operators. =Total Anterior Deficiency.=—In this condition there is a scooped-out or general curved-in appearance of the entire anterior nasal line. The lobule of the nose is usually normal in size. This defect should be corrected by two injections of the paraffin compound previously referred to. The points of injection should be lateral and anterior to the angular vessel on the side of the nose preferred by the operator—one about the center or major curvature and the other about the inferior third. Care should be taken to mold the injected mass as narrow as possible, or as much as the skin will permit. If the latter is bound down it should be mobilized by subcutaneous dissection or levation. A subsequent injection should not be undertaken until the entire mass has become settled or fairly organized, which is about the end of three weeks. The mass should be injected well up to the root of the nose to give it the appearance of the normal bridge. If this is found impossible owing to a dividing skin attachment, a third needle puncture should be made at a point on a level with the internal canthus. [Illustration: FIG. 299. FIG. 300. ANTERIOR TOTAL NASAL DEFICIENCY AND CORRECTION THEREOF.] Care must be exercised to keep the mass from creeping into the loose tissue about the internal canthi by having an assistant press the sides of the nose at that point with the thumb and forefinger. This undesirable condition is much more liable to occur when a hot liquid paraffin is employed, since the operator can observe quite accurately the extent and direction taken by the mass injected when the cold product is used.