Complications after facial contour augmentation with injectable silicone. Diagnosis and treatment. Report of a severe case.
The purpose of this article is to increase the practitioner's awareness of the adverse effects associated with the clinical utilization of foreign bodies (heterofillers), especially silicones for contour augmentation of the face. Diagnostic modes for such difficult cases as well as means for their treatment are discussed in the light of a severe case of facial siliconomas. The case of a 46-year-old female patient with severe facial irregularities and pain secondary to siliconomas 5 years after facial augmentation with silicone is presented. The patient was treated surgically after histological and radiographical confirmation of the diagnosis of facial siliconomas. Extensive dissection of the siliconomas and infiltrated surrounding fascial planes was performed. The patient underwent a protracted course of oral minocycline followed by facial lipofilling with autogenous fat for correction of residual contour irregularities. Silicone may produce unpredictable and devastating complications, which are difficult if not impossible to treat adequately. It is cautious not to use foreign bodies that are not approved by the FDA as contour enhancers, especially not in large quantities.
Maxillofacial Surgery, Mount Sinai School of Medicine, New York, USA. ganastassov@mfss.net
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Anastassov
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Schulhof
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Lumerman
D000273:Adipose Tissue / Q000637:transplantation; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000009:adverse effects*; D001706:Biopsy; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004210:Dissection; D005145:Face / Q000601:surgery*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D012828:Silicones / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous
D000893:Anti-Inflammatory Agents; D001672:Biocompatible Materials; D012828:Silicones; D008911:Minocycline