Despite the documented dangers of illegal silicone injections, there still seems to be a market for these types of treatments—so much so that the International Society of Aesthetic Plastic Surgery (ISAPS) just released a worldwide warning to consumers against these sometimes disfiguring procedures. The warning comes after a year of countless stories of sometimes-lethal underground injections.
With what we know about lethal backroom injections, one would think that the days of the Cardi B.–style butt enhancements were over, however, the latest ISAPS safety statement aims to educate consumers about the serious and sometimes permanent side effects that can occur. Risks include chronic pain, scarring, tissue death, permanent disfigurement, infections and sometimes death. “Illicit silicone and biopolymers, or polyacrilimide gels, are a patient safety concern both in terms of fatalities and late-term complications such as scarring and inflammatory nodules,” says Eugene, OR plastic surgeon Mark Jewell, MD. “These permanent fillers produce permanent complications.”
The Type of Silicone
The promise of a cheap, quick fix may be tempting, but many paitents don’t know what they’re having put in their bodies, or more importantly how their bodies are going to react. “Silicone is a rubber-like polymer that has a similar chemical structure to many substances we see in life, with one difference: instead of a carbon backbone, the backbone is silicon,” explains Nashville plastic surgeon Daniel Hatef, MD. “It’s created in labs around the world for industrial and medical means.”
Inflammatory Responses
One of the aims of ISAPS warning is to urge consumer who’ve had these products injected into their bodies to seek out a doctor as the presence of silicone-free material injected into breasts and buttocks can generate a chronic inflammatory reaction. “That inflammatory response, if it decides not to turn off, will never turn off,” says Vero Beach, FL plastic surgeon Alan J. Durkin, MD. “This can include giant body reactions like disfigurement, hardness, migration, granulomas, tissue breakdown and more.”
Those granulomas and nodules can also confuse clinical breast exams and imaging studies that detect breast cancer. ISAPS is urging anyone who has undergone these types of injections to have a proper evaluation. “Diagnostic ultrasound is a method to monitor the tissues and localize the illicit filler material,” says Dr. Jewell. “Diagnostic ultrasound, 3-D mammography, and MRI imaging are useful ways to evaluate breast tissue when illicit fillers are present.”
Injection Risks
The other issue with these types of permanent enhancements is improper anatomical placement by untrained injectors. “Complications often occur when injectors are not medically trained. They’re often and are doing it from their homes or a hotel room,” adds Houston plastic surgeon German Newall, MD. “The placement of the injections is critical because if any type of injection hits a blood vessel, then the material can travel through the bloodstream to the heart, brain, or lungs and cause silicone pulmonary embolism which is fatal. The injections can leave behind hard, unsightly lumps across the area that are oftentimes impossible to correct.”
Irregularities and Deformities
Unfortunately, many of the negative side effects of these injections are permanent, but there are some surgical options for certain patients. Because of the complexity of the issue, Dr. Newall refers patients with silicone injections to reconstructive plastic surgeons who typically deal with these types of cases. “I have met a few people over the course of my career who have undergone injections with silicone into the buttocks and breasts, usually performed in countries other than the USA, and they have all had numerous very firm, solid masses in their tissues which were very uncomfortable, and in some cases visually deforming.”
As many of the surgeons interviewed for this story noted, surgical correction is extremely difficult, and many patients do not elect to go through with surgery. “It’s almost impossible to reverse or fix. Treatment can include surgical removal of the masses, direct reconstruction, or fat grafting in order to camouflage the unsightly lumps and bumps,” explains Dr. Newall.
These warnings serve to educate consumers on the dangers associated with going to the wrong provider or using the wrong products so that these outcomes stop occurring around the world. “Patients should always ask about the type of filler used and also check the license status of their injector,” adds Dr. Jewell. “Patients should not be relying on large volumes of fillers to enhance breast, body, or face.”
