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Abstract
BACKGROUND There is no standardized approach for nonsurgical techniques for penile augmentation despite the increase of demand for this intervention. OBJECTIVE To compare the efficacy and safety between different injection techniques. MATERIALS AND METHODS On October 8, 2019, a literature search was performed on PubMed, Embase, Ovid, and Cochrane database. All articles describing penile augmentation were included. RESULTS Thirteen studies were included in this article with a total of 1,311 patients. Five studies were prospective cohort. The most commonly described technique was hyaluronic acid fillers with a total of 4 articles and 205 patients. The mean injected volume ranged from 20 to 40 mL. In all included studies, a minority of patients had side effects, but some had disabling complications. CONCLUSION There are no defined clinical guidelines for penile augmentation techniques implemented yet. Hyaluronic acid seems to be safe, efficient, and with a high satisfaction score. Further randomized control trials are warranted. EBM LEVEL OF EVIDENCEBASED MEDICINE 2a.
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Sharobaro VI, Manturova NE, Ivanov YV, Avdeev AE, Zabozlaev FG, Telnova AV. [Injected non-absorbable fillers in large volumes]. Khirurgiia (Mosk) 2019:42-51. [PMID: 31120446 DOI: 10.17116/hirurgia201904142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM To present treatment strategy for large volumes of injectable non-absorbable 'shell-less' soft tissue fillers (vaseline, synthol, silicone etc.). MATERIAL AND METHODS The authors present an experience of surgical treatment of 8 patients who underwent injections of medical vaseline (breast augmentation, n=5) and synthol (muscles enlargement, n=3) and review of the current literature devoted to this problem. RESULTS Injection of large amounts (over 50 ml) of non-absorbable fillers into soft tissues is unacceptable and leads to numerous complications. Oil-based 'shell-less' fillers cannot be removed by minimally invasive techniques (puncture, mini-incisions, etc.) due to multiple diffuse lesions in the form of oleogranulomas (cysts of different size) and surrounding widespread inflammation and fibrosis of tissues. Surgery is the only adequate method. However, this approach is followed by scars and often tissue contour deformation. Migration of these fillers to other anatomical areas (from the neck to the lower extremities) significantly complicates the situation, treatment and results. In case of categorical refusal of patients from surgical treatment and no complaints, they should be properly informed about possible consequences and complications and dynamic medical supervision is necessary. Intraoperative ultrasound examination is useful for the control of radical removal of pathological areas. Timely removal of non-absorbable fillers allows to avoid serious complications and to achieve good aesthetic results.
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Affiliation(s)
- V I Sharobaro
- Federal Research Clinical Center of Specialized Types of Medical Care and Medical Technologies, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - N E Manturova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Yu V Ivanov
- Federal Research Clinical Center of Specialized Types of Medical Care and Medical Technologies, Moscow, Russia
| | - A E Avdeev
- Institute of Beauty on Arbat, Moscow, Russia
| | - F G Zabozlaev
- Federal Research Clinical Center of Specialized Types of Medical Care and Medical Technologies, Moscow, Russia
| | - A V Telnova
- Federal Research Clinical Center of Specialized Types of Medical Care and Medical Technologies, Moscow, Russia
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Chung EJ, Jun DR, Kim DW, Han MJ, Kwon TK, Choi SW, Kwon SK. Prevention of polydimethylsiloxane microsphere migration using a mussel-inspired polydopamine coating for potential application in injection therapy. PLoS One 2017; 12:e0186877. [PMID: 29095854 PMCID: PMC5667927 DOI: 10.1371/journal.pone.0186877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022] Open
Abstract
The use of injectable bulking agents is a feasible alternative procedure for conventional surgical therapy. In this study, poly(dimethylsiloxane) (PDMS) microspheres coated with polydopamine (PDA) were developed as a potential injection agent to prevent migration in vocal fold. Uniform PDMS microspheres are fabricated using a simple fluidic device and then coated with PDA. Cell attachment test reveals that the PDA-coated PDMS (PDA-PDMS) substrate favors cell adhesion and attachment. The injected PDA-PDMS microspheres persist without migration on reconstructed axial CT images, whereas, pristine PDMS locally migrates over a period of 12 weeks. The gross appearance of the implants retrieved at 4, 8, 12 and 34 weeks indicates that the PDA-PDMS group maintained their original position without significant migration until 34 weeks after injection. By contrast, there is diffuse local migration of the pristine PDMS group from 4 weeks after injection. The PDA-coated PDMS microspheres can potentially be used as easily injectable, non-absorbable filler without migration.
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Affiliation(s)
- Eun-Jae Chung
- Department of Otorhinolaryngology, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dae-Ryong Jun
- Department of Biotechnology, The Catholic University of Korea, Gyeonggi-do, Korea
| | - Dong-Wook Kim
- Department of Otorhinolaryngology, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Mi-Jung Han
- Department of Otorhinolaryngology, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Tack-Kyun Kwon
- Department of Otorhinolaryngology, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung-Wook Choi
- Department of Biotechnology, The Catholic University of Korea, Gyeonggi-do, Korea
- * E-mail: (SKK); (SWC)
| | - Seong Keun Kwon
- Department of Otorhinolaryngology, College of Medicine, Seoul National University Hospital, Seoul, Korea
- * E-mail: (SKK); (SWC)
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Lanzarotta A, Kelley CM. Forensic Analysis of Human Autopsy Tissue for the Presence of Polydimethylsiloxane (Silicone) and Volatile Cyclic Siloxanes using Macro FT-IR, FT-IR Spectroscopic Imaging and Headspace GC-MS. J Forensic Sci 2016; 61:867-874. [PMID: 27122436 DOI: 10.1111/1556-4029.13018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/08/2015] [Accepted: 06/22/2015] [Indexed: 11/29/2022]
Abstract
This study describes effective and straightforward primary and secondary methods for the detection of silicone in human autopsy tissue. The primary method is polydimethylsiloxane (PDMS) specific and employs either macro-attenuated total reflection Fourier transform infrared (ATR-FT-IR) spectroscopy for samples with a high PDMS concentration (relative to that of the matrix) or micro-FT-IR spectroscopic imaging in a reflection/absorption modality for samples with a low PDMS concentration. Although the secondary method is not PDMS specific, it employs headspace gas chromatography with mass spectrometric detection (HS/GC-MS) for the detection of low molecular weight volatile cyclic siloxanes (VCS), which are characteristic marker compounds for PDMS. Overall, the combined results from the primary and secondary analyses provide reliable evidence for the presence of silicone.
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Affiliation(s)
- Adam Lanzarotta
- United States Food and Drug Administration, Forensic Chemistry Center, Cincinnati, OH, 45237
| | - Caroline Machal Kelley
- United States Food and Drug Administration, Forensic Chemistry Center, Cincinnati, OH, 45237
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Crowe JB, Lanzarotta A, Witkowski MR, Andria SE. Analysis of Hypodermic Needles and Syringes for the Presence of Blood and Polydimethylsiloxane (Silicone) Utilizing Microchemical Tests and Infrared Spectroscopy. J Forensic Sci 2015; 60:1078-84. [PMID: 25782994 DOI: 10.1111/1556-4029.12763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 11/28/2022]
Abstract
Suspect hypodermic needles and syringes were seized from an unlicensed individual who was allegedly injecting patients with silicone (polydimethylsiloxane [PDMS]) for cosmetic enhancement. Since control syringe barrels and needles often contain an interfering PDMS lubricant, a risk for false positives of foreign PDMS exists. The focus of this report was to minimize this risk and determine a quick and reliable test for the presence of blood in PDMS matrices. Using ATR-FT-IR spectroscopy, the risk for false-positive identification of foreign PDMS was reduced by (i) overfilling the sampling aperture to prevent spectral distortions and (ii) sampling a region of the suspect syringe/needle assembly where manufacturer-applied PDMS is not typically located. Analysis for blood indicated that the Teichman microchemical test was effective for detecting blood in the presence of PDMS. Overall, detecting PDMS established intent and detecting blood established that the needle containing the PDMS had been used for injection.
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Affiliation(s)
- John B Crowe
- United States Food and Drug Administration, Forensic Chemistry Center, Trace Examination Section, Cincinnati, OH, 45237
| | - Adam Lanzarotta
- United States Food and Drug Administration, Forensic Chemistry Center, Trace Examination Section, Cincinnati, OH, 45237
| | - Mark R Witkowski
- United States Food and Drug Administration, Forensic Chemistry Center, Trace Examination Section, Cincinnati, OH, 45237
| | - Sara E Andria
- United States Food and Drug Administration, Forensic Chemistry Center, Trace Examination Section, Cincinnati, OH, 45237
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Severe granulomatous reaction associated with hypercalcemia occurring after silicone soft tissue augmentation of the buttocks: a case report. Aesthetic Plast Surg 2014; 38:95-99. [PMID: 24281899 DOI: 10.1007/s00266-013-0167-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Liquid silicone is a permanent filler. Its use to augment soft tissues for aesthetic purposes was widespread worldwide in the 1960s. Although initially considered to be biologically inert, this substance may cause, after its injection, an inflammatory granulomatous effect of variable severity and, in very rare cases, a severe hypercalcemia, which can be life threatening. The reported case highlights the well-known physiopathology of hypercalcemia, and the various therapeutic options are discussed. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Chevallier D, Haertig A, Faix A, Droupy S. Chirurgie cosmétique de l’appareil génital masculin. Prog Urol 2013; 23:685-95. [DOI: 10.1016/j.purol.2013.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 02/18/2013] [Indexed: 11/29/2022]
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Ferneini E, Boynton T, Almunajed H, Dimitrov K, Banki M. Review of Facial Fillers and Injectable Neurotoxins. ACTA ACUST UNITED AC 2013. [DOI: 10.5992/ajcs-d-12-00028.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Noninvasive cosmetic techniques continue to increase in popularity. In particular, dermal fillers and botulinum toxin injectables have consistently shown a rise in demand. Pharmaceutical companies have spent millions of dollars to develop these products to produce more achievable, predictable, and long-lasting results. As a result, multiple products were developed that differ in their physical and chemical properties. By understanding these characteristics, the cosmetic surgeon will achieve more safe and reliable results. Materials and Methods: A literature search on dermal fillers and botulinum toxin injectable treatments was completed from 2005 to 2013. Results: Injectables are a great resource for clinicians to improve a patient's appearance in a short time with relatively little discomfort to the patient. With a rise in the number of patients requesting these treatments, it is crucial that the surgeon and patient are aware of all of the risks and benefits of treatment. As the quest for the youthful image continues in our society, anti-aging therapies will continue to improve. Conclusions: Patients and cosmetic surgeons will continue to work with these and more advanced products as they are approved. With proper training and experience, the surgeon should be able to provide treatments that consistently benefit their patients. It is the purpose of the paper to provide the cosmetic surgeon with a description of the current products available as well as the complications that can arise when using these materials.
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Tealab AA, Maarouf AM, Habous M, Ralph DJ, Abohashem S. The use of an acellular collagen matrix in penile augmentation: A pilot study in Saudi Arabia. Arab J Urol 2013; 11:169-73. [PMID: 26558077 PMCID: PMC4442917 DOI: 10.1016/j.aju.2013.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 01/30/2013] [Accepted: 02/16/2013] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the use of an acellular collagen matrix (Pelvicol, Bard Medical, Covington, GA, USA), a successful agent for reconstructive surgery, for enhancing penile girth. PATIENTS AND METHODS Between June and December 2011, 18 patients (mean age 24 years, range 19-38) had their penis augmented with Pelvicol; the mean (range) penile circumference was 9.2 (7-13) cm before treatment. They were divided into two groups; the first (10 patients) had a Pelvicol sheet of 8 × 12 cm inserted through a V-Y suprapubic incision and wrapped around the shaft in a bilayer under the dartos fascia, but not covering the urethra, with division of the suspensory ligament. The second group of eight patients had the Pelvicol inserted through a subcoronal degloving incision and placed in one layer. The penile circumference was measured at 6 and 12 months after surgery. Patient satisfaction at 1 year after surgery was assessed as 'poor', 'unsatisfied', 'moderately satisfied', 'highly satisfied', or 'excellent'. RESULTS The mean (range) increase in girth (circumference) was 2.8 (2-3.2) cm in group 1 and 1.7 (1.2-2) cm in group 2. In group 1, two patients were highly satisfied, four moderately satisfied and four unsatisfied; in group 2, three were moderately satisfied and five unsatisfied. Complications were common in both groups, with five patients in group 1 and three in group 2 developing severe penile oedema and ischaemic shaft ulcers. Removal of the graft was required in two patients in each group. CONCLUSION This pilot study shows that Pelvicol is not an ideal option for enhancing penile girth, and the method of placement did not apparently influence the result.
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Affiliation(s)
- Alaa A. Tealab
- Elaj Medical Centre, Jeddah, Saudi Arabia
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Corresponding author address: Urology Department, Faculty of Medicine, Zagazig University, Zagazig 12345, Egypt. Tel.: + 966594084879; fax: + 966048157060.
| | - Aref M. Maarouf
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | - Safwat Abohashem
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Luebberding S, Alexiades-Armenakas M. Critical Appraisal of the Safety of Dermal Fillers: A Primer for Clinicians. CURRENT DERMATOLOGY REPORTS 2013. [DOI: 10.1007/s13671-013-0042-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sasidaran R, Zain MAM, Basiron NH. Low-grade liquid silicone injections as a penile enhancement procedure: Is bigger better? Urol Ann 2012; 4:181-6. [PMID: 23248528 PMCID: PMC3519113 DOI: 10.4103/0974-7796.102672] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 04/09/2011] [Indexed: 11/29/2022] Open
Abstract
To report our experience with 5 cases of complications of penile enhancement procedures secondary to liquid silicone injections and our method of management of its debilitating effects. All five patients were treated with excision of penile shaft skin down to buck's fascia followed by resurfacing with split thickness skin grafting. We conclude that penile enhancement procedures with liquid silicone by non-medical personnel could result in devastating consequences. We also demonstrate that a simple method of excision of the entire penile shaft skin and resurfacing with split skin grafting showed improvement in cosmetic as well as functional outcome.
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Affiliation(s)
- Ramesh Sasidaran
- Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-needle intradermal fat grafting (SNIF). Aesthet Surg J 2012; 32:554-61. [PMID: 22745443 DOI: 10.1177/1090820x12445082] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Reversing the effects of facial aging is best accomplished with a combination of techniques. Minimizing the appearance of fine wrinkles is an essential part of treatment, which can involve resurfacing, intradermal filler injections, or a combination of the two. The quest for the ideal filler material is ongoing, but intradermal fat injections can serve as an inexpensive and safe alternative to classic intradermal fillers. OBJECTIVES The aim of this study was to evaluate the feasibility, validity, and safety of the sharp-needle intradermal fat grafting (SNIF) technique. METHODS The records of 250 consecutive patients treated over a 3-year period with the authors' SNIF technique were reviewed to evaluate the SNIF technique and its results, including complications. RESULTS Results were evaluated by clinical examination and patient photographs. Good improvement was achieved with SNIF, with results lasting more than 1 year, which exceeds the expected duration for resorbable dermal fillers (typically 3 to 6 months). No major complications occurred; the most common minor complications were bruising and swelling. CONCLUSIONS SNIF is a safe and effective alternative to classic resorbable dermal fillers for patients who can accept the minor discomfort involved in extracting fat from the donor site. The harvesting and injection techniques should be performed with precision to achieve favorable results and avoid complications.
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Affiliation(s)
- Assaf A. Zeltzer
- Dr Zeltzer is an attending plastic surgeon at the University Hospital, Brussels, Belgium
| | - Patrick L. Tonnard
- Dr Tonnard and Dr Verpaele are plastic surgeons in private practice in Gent, Belgium
| | - Alexis M. Verpaele
- Dr Tonnard and Dr Verpaele are plastic surgeons in private practice in Gent, Belgium
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Moor EV, Olshinka A, Ad-El D. Surgical Technique for Remodelling Lip Deformities Due to Overinjection of Silicone Oil. Dermatol Surg 2012; 38:1049-53. [DOI: 10.1111/j.1524-4725.2012.02381.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Camacho D, Machan S, Pilesanski U, Revelles JM, Martín L, Requena L. Generalized Livedo Reticularis Induced by Silicone Implants for Soft Tissue Augmentation. Am J Dermatopathol 2012; 34:203-7. [DOI: 10.1097/dad.0b013e31821cb3c5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adverse reactions to injectable soft tissue fillers. J Am Acad Dermatol 2011; 64:1-34; quiz 35-6. [DOI: 10.1016/j.jaad.2010.02.064] [Citation(s) in RCA: 210] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Revised: 01/29/2010] [Accepted: 02/02/2010] [Indexed: 11/23/2022]
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Wallace PM, Rasmussen S. Analysis of Adulterated Silicone: Implications for Health Promotion. Int J Transgend 2010. [DOI: 10.1080/15532739.2010.514222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Crews RM, Jennings JA, McCanless J, Cole JA, Bumgardner JD, Haggard WO. The characterization and optimization of injectable silicone resin particles in conjunction with dermal fibroblasts and growth factors: an in vitro study. J Biomed Mater Res B Appl Biomater 2010; 93:227-35. [PMID: 20091922 DOI: 10.1002/jbm.b.31579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Minimally invasive subdermal injection of liquid silicone has been used clinically to augment the soft tissue of the foot to mitigate high pressures that cause diabetic foot ulcers. However, implant migration has been a clinical issue. The objective of this study was to assess the effects of three specific concentrations of silicone resin particles (12 mum average diameter) in conjunction with either platelet-derived growth factor (PDGF-BB) or basic fibroblast growth factor (bFGF) on fibroblast cell proliferation, collagen synthesis, cell morphology, and migration through in vitro assays and a monolayer scratch wound model. PDGF and bFGF enhanced the proliferation of fibroblasts 5.7-fold and fivefold, respectively, while the addition of silicone particles had no significant effect on proliferation. Collagen production was increased approximately twofold with the addition of bFGF and the medium concentration of particles over bFGF without particles and the PDGF groups. The addition of silicone particles had no significant effect on collagen production compared with control groups without particles. Fibroblast migration was enhanced by the addition of both PDGF and bFGF compared to controls, although slower scratch wound closure rates were observed in the presence of particles compared to controls without particles. Cell morphology suggested that particles induced cellular aggregation encircling silicone particles postwounding as well as migration into the wound area. These results suggest that silicone particles in combination with a growth factor might enhance fibroblast aggregation and implant stability, and could promote connective tissue ingrowth and implant encapsulation in the soft tissue of the diabetic foot.
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Affiliation(s)
- Robert M Crews
- Department of Biomedical Engineering, The University of Memphis, Memphis, Tennessee 38152, USA.
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Jennings JA, Crews RM, Robinson J, Richelsoph K, Cole JA, Bumgardner JD, Yang Y, Haggard WO. Effect of growth factors in combination with injectable silicone resin particles on the biological activity of dermal fibroblasts: a preliminary in vitro study. J Biomed Mater Res B Appl Biomater 2010; 92:255-60. [PMID: 19904740 DOI: 10.1002/jbm.b.31512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Injections of silicone fluid have been clinically evaluated to treat and prevent foot ulcers due to diminished plantar fat-pad in neuropathic diabetics. The objective of this study was to determine preliminary in vitro effects of an injectable form of silicone resin particles in combination with growth factors to determine the suitability of this potential therapy for prevention of diabetic foot ulcers. Basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and platelet-derived growth factor (PDGF-BB) were added to monolayer culture along with silicone resin particles (12 microm average diameter). Growth factors were also combined as follows: bFGF+PDGF-BB, EGF+PDGF-BB, and bFGF+EGF. Growth factors alone and in combination increased fibroblast proliferation, but the presence of particles did not significantly affect cellular proliferation. The addition of particles significantly increased fibronectin production 117% in the control group and 151% in the PDGF only group. Collagen production was increased with exposure to EGF and growth factor combinations, but the presence of particles did not lead to any significant differences, except an 81% increase in the bFGF group. These preliminary results suggest that a combination of PDGF and bFGF may be effective in stimulating proliferation and matrix production around injectable silicone resin particles to generate a fibrous tissue pad to alleviate the abnormal distribution of high pressures that contribute to diabetic foot ulcer formation.
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Affiliation(s)
- Jessica A Jennings
- Department of Biomedical Engineering, The University of Memphis, Memphis, Tennessee 38152, USA.
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Plaza T, Lautenschlager S. Penis swelling due to foreign body reaction after injection of silicone. J Dtsch Dermatol Ges 2010; 8:689-91. [PMID: 20337774 DOI: 10.1111/j.1610-0387.2010.07427.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 19-year-old man presented with phimosis and painful swelling of the penis four weeks after augmentation with silicone in Thailand. Histology revealed a foreign body reaction to silicone. Infectious causes were ruled out. Granulomatous foreign body reactions to silicone are common, but there are few case reports on reactions following silicone injection for penis enlargement. Foreign body reactions should be included in the differential diagnosis of penis swelling.
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Affiliation(s)
- Tobias Plaza
- Dermatology Office Dr. Tobias Plaza, Uster, Switzerland.
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Michaels B, Michaels J, Mobini N. Prominent lymphoid infiltrate with a pseudolymphoma-like morphology: a new histological finding of injectable liquid silicone. J Cutan Pathol 2009; 36:1224-6. [DOI: 10.1111/j.1600-0560.2009.01328.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes. Plast Reconstr Surg 2009; 123:1842-1863. [DOI: 10.1097/prs.0b013e31818236d7] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
We report a case of multisystem organ failure after large volume subcutaneous injection of castor oil for cosmetic enhancement. An unlicensed practitioner injected 500 mL of castor oil bilaterally to the hips and buttocks of a 28-year-old male to female transsexual. Immediate local pain and erythema were followed by abdominal and chest pain, emesis, headache, hematuria, jaundice, and tinnitus. She presented to an emergency department 12 hours postinjection. Persistently hemolyzed blood samples complicated preliminary laboratory analysis. She rapidly deteriorated despite treatment and developed fever, tachycardia, hemolysis, thrombocytopenia, hepatitis, respiratory distress, and anuric renal failure. An infectious diseases evaluation was negative. After intensive supportive care, including mechanical ventilation and hemodialysis, she was discharged 11 days later, requiring dialysis for an additional 1.5 months. Castor oil absorption was inferred from recovery of the Ricinus communis biomarker, ricinine, in the patient's urine (41 ng/mL). Clinicians should anticipate multiple complications after unapproved methods of cosmetic enhancement.
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A Critical Analysis of Penile Enhancement Procedures for Patients with Normal Penile Size: Surgical Techniques, Success, and Complications. Eur Urol 2008; 54:1042-50. [DOI: 10.1016/j.eururo.2008.07.080] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Accepted: 07/30/2008] [Indexed: 11/19/2022]
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Ren TB, Weigel T, Groth T, Lendlein A. Microwave plasma surface modification of silicone elastomer with allylamine for improvement of biocompatibility. J Biomed Mater Res A 2008; 86:209-19. [DOI: 10.1002/jbm.a.31508] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lemperle G, Rullan PP, Gauthier-Hazan N. Avoiding and treating dermal filler complications. Plast Reconstr Surg 2006; 118:92S-107S. [PMID: 16936549 DOI: 10.1097/01.prs.0000234672.69287.77] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of and accept these risks. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., too superficial an implantation of a long-lasting filler substance). Such adverse events can be treated with intradermal 5-fluorouracil, steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions shall remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granuloma in the subcutaneous fat.
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Fulton JE, Porumb S, Caruso JC, Shitabata PK. Lip Augmentation with Liquid Silicone. Dermatol Surg 2006; 31:1577-85; discussion 1586. [PMID: 16416641 DOI: 10.2310/6350.2005.31244] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many fillers have been used to augment the lips. One of these that has provided long-term satisfactory results is liquid silicone. OBJECTIVE To demonstrate the efficacy and safety of lip augmentation with liquid silicone. METHOD Following a discussion of the benefits and risks of the procedure and the benefits and risks of alternatives and after answering all of the patients' questions, an informed consent form was signed. After obtaining anesthesia with a regional nerve block of the infraorbital and mental nerves, 0.25 to 0.5 cc of liquid silicone (1,000 centistokes) was injected using the microdroplet technique into the vermilion border of both the upper and lower lips. Depending on the desire of the patient, the procedure was repeated monthly. The augmentation of the lips was documented with histology, micrometry, and digital photography. RESULTS Lip augmentation was achieved gradually during the months following liquid silicone injections into the vermilion border of the lips in the 608 patients studied. Most of the patients requested a second and third injection session. The results were most dramatic in the patients with type I and type II lips and less satisfactory in patients with type III lips. Bruising occurred in the majority of the patients. Eleven patients (2%) developed small palpable granulomas. These granulomas either required no treatment, responded to steroid injections, or were excised. CONCLUSION The use of liquid silicone remains an effective method of lip augmentation. It returns the adolescent vermilion curl to the lips.
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Affiliation(s)
- James E Fulton
- Vivant Skin Care, Inc, 1801 Coral Way, Suite 300, Miami, FL 33145, USA.
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Jacinto SS. Ten-Year Experience Using Injectable Silicone Oil for Soft Tissue Augmentation in the Philippines. Dermatol Surg 2006; 31:1550-4; discussion 1554. [PMID: 16416637 DOI: 10.2310/6350.2005.31240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND No ideal, permanent filler is approved by the U.S. Food and Drug Administration. Repeated injections of new temporary fillers make this cosmetic procedure expensive. OBJECTIVE To show that silicone oil is effective, safe, economical, and permanent. MATERIALS AND METHOD The age, sex, number, indications, sites, adverse reactions, total amounts injected, and clinical cosmetic results of 206 cases were tallied. RESULTS Females (82%) outnumbered males (18%). The majority were in the 21- to 30-year age group. Fifty-five percent had acne scars, 42% nasolabial grooves, 13.5% marionette lines, 12.6% glabellar lines, 9.8% postvaricella scars, 9.3% inframalar depressions, 1.8% post-traumatic scars, 1.4% lipodystrophy, 1% lip augmentation, 0.9% sleep lines, and 0.4% contour defect. Fifty-one percent had < or = 0.5 cc, 22% 1 cc, 7% < or = 1.5 cc, 7% < or = 2 cc, and 12% >2 cc. Clinical improvement was graded excellent (76-100%), good (50-75%), fair (26-50%), and poor (< 25%). Seventy-two percent had excellent results, 18% good, 2% fair, and 0.5% poor. Seven percent were lost to follow-up. Two percent (n=5) had transient erythematous papules lasting 2 to 6 weeks, with the exception of two patients. CONCLUSION Silicone oil injected with the correct indications and techniques and with microdroplet injections is a safe, economical, and permanent dermal and subcutaneous filler. Rare permanent erythematous papules and transient ecchymoses appear on deep dermal injections.
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Abstract
The histological aspects of resorbable heterologous fillers (bovine collagen, acid hyaluronique), autologous fillers (lipofilling, dermis-fat graft), biodegradable fillers (New-Fill), and permanent fillers (silicone, Artecoll, Evolution, Aquamid, DermaLive, DermaDeep, Bioplastique, Paraffin) are described. This article relates the morphological aspect of these materials, the normal tissue reaction after injection, and its chronological evolution as the morphological aspects from the different side effects, more frequently observed for the permanent fillers. They mainly consist of granulomatous reactions which may appear long after injection.
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