Unfortunately, there have been numerous cases of foreign materials injected into the body (into the buttocks and thighs, for instance), performed by unlicensed or unskilled practitioners. These foreign material injections included but not limited to Silicone, Biogel, Hydrogel, Biopolymer, PMMA, and Aqua gel are not-FDA approved for body contouring, and are extremely harmful to the human body. Side effects can include ongoing pain and serious injuries, such as scarring, tissue death, and permanent disfigurement. These materials have been implicated in a variety of adverse reactions including granulomas, disfiguring nodules, and lymphedema, sometimes with latent periods of decades. Often, they may cause disfiguring chronic infections that may require intravenous antibiotics or extensive surgical debridement. If the silicone migrates beyond the injection site, it could cause an embolism, stroke, infections and death. Serious complications may occur right away or could develop weeks, months, or years later. There had been a few cases that the chronic infections resulting from illegally injected industrial grade products into the lower extremities, such as the legs, resulted in amputations as a life-saving procedure.
Clinical Manifestation of Silicone Toxicosis
On a daily basis, many patients visit our clinic looking for a permanent solution to some of the following adverse and common symptoms:
Chronic infection, such as cellulitis, that are recurrent despite antibiotics. Fever (above 100.4 F) is another symptom experienced by patients.
Firmness or hardening of the area of injections.
Chronic pain, such as buttock pain or pain in the outer thighs, for instance.
Numbness sensation of the area treated with foreign material injections
Discoloration of the skin of the area of injection.
Treatment of Silicone toxicosis
Patients should seek immediate medial attention if they experience problems such as difficulty breathing, chest pain, signs of a stroke (including sudden difficulty speaking, numbness or weakness in the face, arms, or legs, difficulty walking, face drooping, severe headache, dizziness, or confusion), as it may be a life-threatening situation.
Typically, Dr. De La Cruz recommends his patients getting a Magnetic Resonance Imaging (MRI) scan to evaluate the location of the injected material, the extent of injection, as well as the area where the foreign material may potentially have migrated. The MRI results would act as helpful guiding map to determine where Dr. De La Cruz would remove the Biopolymer. Depending on the patient particular situation, the management and treatment of silicone toxicosis may vary. The treatment plan for Silicone toxicosis ranges from surgical excision, to hyaluronidase injections followed by VASER Liposuction and transfer into the area to correct the resultant deformity. Complete removal, such as surgical excision, may result in a life-changing deformity.
Hyaluronidase is a natural occurring enzyme in our tissue that modifies our own hyaluronic acid. Hyaluronidase injections are considered very safe and have been used for years for non-cosmetic purposes in medicine before being used in cosmetic surgery to facilitate the removal of dermal fillers. Dr. De La Cruz usually applies Hyaluronidase injections to his patients at least 2-3 days before the Biopolymer removal procedure in order to soften the harmful material. The volume of Hyaluronidase needed varies greatly among patients depending on their specific situation.
The Vaser Liposuction and fat transfer solution
Vaser Liposuction is an advanced body contouring procedure that selectively remove unwanted body fat. This method uses minimally-invasive ultrasound technology to emulsify fat while leaving all other important tissues intact. resulting in significant desirable effects with minimal damage to surrounding tissues. Consequently, patients recover considerably quicker as they suffer reduced bleeding, bruising and swelling in the treated areas. The shorter recovery time needed for VASER Liposuction makes it more convenient and appealing to patients, who may return to their work and regular activities as soon as one week after the surgery.
Another reason why Dr. De La Cruz recommends VASER Liposuction over other alternatives is the remarkable advantage of using the extracted excess fat to safely transfer it into specific areas (such as thighs and buttocks) to correct the resultant deformity after Biopolymer removal. This process is called Fat Transfer Procedure or Fat Grafting. It's important noticing that fat cells treated and removed during VASER Lipo procedures are typically of high quality (in contrast with the ones extracted via Smart Lipo and other traditional lipolysis methods), and are viable to re-introduce into the body. Unlike short lasting synthetic fillers, re-injecting your own fat may give you natural looking results that last longer, with no risk of rejection. This favorable possibility to treat the silicone toxicosis and contour your body by using your own fat in a single procedure is definitely one big plus for VASER Liposuction with fat transfer. Since every case is different, patients would need to be evaluated by Dr. De La Cruz and an MRI may be necessary to determine the best suitable treatment plan.
Silicone/Biopolymer Removal complications
Fortunately, this procedure is fairly safe because of advances in technology. As with every procedure, there are some risks associated with biopolymer removal surgery such as fat embolism (a rare complication when fat is injected into the bloodstream and travels to the lungs), numbness, bruising, infection (less than 2% risk), necrosis of fat or surrounding tissue, excessive blood loss, and deep vein thrombosis (DVT), among others. However, an experienced and specially trained plastic surgeon as Dr. De La Cruz can help diminish those risks significantly.
Figure 1: Before and After Hydrogel/Biopolymer removal from the buttocks using VASER Liposuction with fat transfer to the buttocks to correct the resulting deformity from removal of the Biopolymers.
Figure 2: Before and After Silicone injections removal with VASER Liposuction and fat transfer to the buttocks. Chronic pain was resolved immediately after surgery.