title: Siliconomas of the lower limb: Tumour-like excision and reconstruction.
abstract: BACKGROUND
  Silicone oil injection can cause several complications including pain, cellulitis, abscesses, skin compromise, migration, embolism and multiorgan failure. Oil-infested tissue excision remains the solely treatment to prevent such complications.
  
  
  OBJECTIVE
  The authors evaluate tumor-like excision of the oil-infested tissue as a treatment for patients experiencing silicone injections in the lower limbs, to both preserve aesthetic appearance and solve further risk of complication from silicone.
  
  
  METHODS
  Between January 2004 and January 2011 a total of 12 consecutive, nonrandomized female patients underwent surgical management of siliconoma of the lower limb. The mean age was 41-years, range from 22 to 61 years and all patients didn't referred comorbidities. Eight siliconomas were located on the leg and 4 were on the thigh. The mean area of siliconoma was 35 cm2, range from 25 to 60 cm2. Each patient was evaluated by ultrasonography and EchocolorDoppler of the soft tissue and in order to achieve a "staging" of siliconoma.
  
  
  RESULTS
  Healing was uneventful in all cases. Three patients (25%) suffering hypertrophic scarring underwent further injection of corticosteroids to improve hypertrophic scars quality. Two patients (16.6%) required a further session of structural fat grafting to improve thigh's profile. All patients were satisfied with the cosmetic results and indispositions requiring medical therapy disappeared.
  
  
  CONCLUSIONS
  Tumor-like excision and immediate reconstruction appears to be a safe and consistent surgical option that preserves aesthetic appearance for patients victims of illegal oil silicone injection of the lower limbs.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Agostini
authors.affiliation: Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Perello
keywords: Reconstruction; silicone; siliconoma functional outcome