The tourists went to tea on day one in Durban at 6-149, with no Australian having passed 50 and South Africa's quicks doing the damage at Kingsmead.
Steve Smith and Marnus Labuschagne fell within four balls of each other either side of lunch, while Alex Carey and Beau Webster followed in quick succession before tea.
But the big story was the selection of Maddinson, after he hadn't been in the squad 10 days ago prior to Josh Inglis fracturing his finger.
The 34-year-old's effort to earn a recall almost a decade after his last Test, and after beating testicular cancer last year, is one of the feel-good stories of sport.
But even before Friday his selection in the squad drew criticism from the likes of Matthew Hayden, given Maddinson hadn't played a first-class game in more than 18 months.
The decision to have Maddinson open the batting and move Matt Renshaw to No.5 also raised eyebrows, given Renshaw was only brought in as opener one Test ago.
Australia's current selectors have routinely got out-of-the-box calls right, and liked Maddinson for Durban with his flexibility and ability to play spin.
But he will need a far better second innings to justify the call.
Thrust into the role, the left-hander lasted 33 balls in Durban before his difficult innings ended when he chopped on from Marco Jansen (2-35).
Maddinson was also lucky to survive his 15th ball when South Africa opted not to review an lbw appeal from Wiaan Mulder that would have been out on ball tracking.
His innings marked for the longest duck on record by an Australian Test opener, and third longest by any opener worldwide.
But the more alarming statistic for critics will be the fact this is the first time Australia have ever fielded a Test side without a single player under the age of 30.
Maddinson's selection next to Head at the top of the order also made for Australia's eighth first-choice opening combination since David Warner retired in January 2024.
The recalled opener wasn't alone with his issues on Friday.
Head clipped two balls off his pads to the boundary before being caught behind down legside off Mulder (2-21) for nine.
Labuschagne look in good touch before before being lbw to Mulder last ball before lunch on 37.
Smith lifted spinner Keshav Maharaj for two sixes down the ground in the left-armer's first over, but then guided Jansen to gully on the third ball after lunch on 25.
And when Anrich Nortje (2-26) had Alex Carey edging to slip on 14 and Beau Webster (4) caught behind two balls later, Australia were 6-124.
Renshaw (32no) was able to see the tourists through to tea alongside Pat Cummins (9no), but the concerns are already apparent for Australia's batting.
Australia were bowled out by Bangladesh for scores of 198, 284 and 210 in August's drawn series at home, after an Ashes summer of highs and lows with the bat.
And while coach Andrew McDonald pointed out this week they were still functioning well enough for his team to be the No.1-ranked in the world, Friday was further proof that they remain vulnerable.
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