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Devastating complications following distant migration of injected silicone: Case report and review of the literature
Paul Durand, MD
Rafael Couto, MD
Ali Totonchi, MD
Cleveland Clinic Foundation;
Metro Health Hospital
2015-03-15
Presenter: Paul Durand, MD
Affidavit:
I certify that this is the original work of my resident Paul Durand, MD.
Director Name: Steven Bernard, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Since its inception in the 1960s and 1970s, injecting liquid silicone for purposes of soft-tissue augmentation remains a popular practice. A lack of public awareness to its devastating complications has allowed unlicensed practitioners to continue subjecting individuals these injections. A varied presentation and delayed onset can make the recognition of these complications quite challenging. Previous reports describe such complications localized to the injection site or adjacent regional tissues. We present the unusual case of a 51-year-old transgender female with distant migration of injected silicone resulting in several complications, including secondary lymphedema and a chronic ankle wound. Upon presentation the patient reported a thirty-year history of bilateral lower extremity lymphedema, chronic inflammation and recurrent cellulitis. These symptoms first manifested one month after an unknown quantity of silicone was injected to both her thighs and hip area in hopes of enhancing her figure. CT scan shows significant soft tissue thickening and calcifications in bilateral gluteal regions and throughout the lower extremities in a diffuse pattern. In addition to this case presentation, we perform a review of the literature outlining proposed management strategies for such dreaded complications.
