A rare autoimmune disorder decimated the cartilage and bone in a woman’s nose, causing her nose to collapse and sink into her face.

When the 34-year-old woman checked into a facial plastic surgery clinic, her nasal bride had completely collapsed, causing the tip of her nose to retract, according to a report published April 5 in The New England Journal of Medicine (NEJM). The deformity had emerged over the course of seven years.