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Daneshi K, Mansour HRK, Pacheco-Barrios N, Asaju A, Pérez Pachon M, Hoyos A, Khajuria A. A Bibliometric Analysis of the Top 100 Papers on Gluteal Augmentation. Aesthet Surg J Open Forum 2024; 6:ojae053. [PMID: 39100865 PMCID: PMC11295219 DOI: 10.1093/asjof/ojae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Abstract
Background Gluteoplasty or gluteal augmentation is a popular cosmetic procedure that is used to improve the volume, shape, and contour of the buttocks. Objectives This bibliometric analysis aims to characterize emerging research trends and to assess the methodological quality of the highest impact gluteoplasty research. Methods The 100 most-cited publications in gluteoplasty were identified on Web of Science, across all available journal years (from Inception to August 2023). Study details, including the citation count, main content focus, and outcome measures, were extracted and tabulated from each publication. Oxford Centre for Evidence Based Medicine level of evidence (LOE) of each study was assessed. Results The 100 most-cited publications regarding gluteoplasty were cited by a total of 2375 publications. Citations per publication ranged from 5 to 176 (mean 23.75 ± 25.86), with the highest-cited study being authored by Simonacci, discussing autologous fat grafting (n = 176). Most publications were LOE 5 (n = 55), representative of the large number of case series and reports. The number of publications for LOE 1, 2, 3, and 4 was 1, 9, 13, and 22, respectively. The main content focus was "surgical technique" in 38 publications, followed by "outcomes" (n = 34) and "risk factors/prognosis" (n = 10). Patient-reported outcome measures (PROMs) were used in 20 publications, and 33 publications reported aesthetic outcome measures. Conclusions This analysis demonstrates a need for improvement in research methodologies regarding gluteoplasty research. This advancement would be facilitated by robust, high-quality research through randomized control trials and multicenter studies, as well as the further development of validated PROMs for gluteoplasty. Level of Evidence 2
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Affiliation(s)
| | | | | | | | | | | | - Ankur Khajuria
- Corresponding Author: Dr Ankur Khajuria, Department of Surgery and Cancer, London W2 1NY, UK. E-mail:
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2
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Atiyeh B, Ghieh F, Oneisi A. Safety and Efficiency of Minimally Invasive Buttock Augmentation: A Review. Aesthetic Plast Surg 2023; 47:245-259. [PMID: 35999464 DOI: 10.1007/s00266-022-03049-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Volume restoration and enhancement of the gluteal region appearance has become nowadays a popular concern in particular for many women. Several options are available, none however are without complications and side effects. Volume enhancement with soft tissue fillers of the gluteal region is emerging as a highly attractive minimally invasive modality. It has led unfortunately to more unlicensed, nonmedical practitioners administering illicitly injections for buttock augmentation at relatively low costs. MATERIALS AND METHODS To determine safety, efficacy, and cost effectiveness of mostly used soft-tissue fillers for buttock augmentation, a systematic literature search of PubMed, Medline, and Embase was conducted to identify the mostly used fillers for gluteal augmentation. It was complemented by searching for each of the identified filler material separately to retrieve any missed reports. References of clinical studies and trials, reviews, and consensus reports were reviewed as well for the same objective. RESULTS In the final analysis 12, mostly strongly biased clinical reports providing a low level of evidence, were identified for inclusion in the review. Two studies involved Polymethylmethacrylate (PMMA), 5 Poly-L-lactic acid, 1 Calcium hydroxyapatite and 4 hyaluronic acid filler injection. No studies were identified involving liquid silicone or Polyacrylamide hydrogel. The little available evidence provided by this review indicates that a specific brand of PMMA in Brazil has a demonstrable relatively good safety, efficiency, and cost-effectiveness record superior to surgical alloplastic gluteal augmentation or to lipofilling only when injected by experts. CONCLUSION Gluteal augmentation with soft tissue fillers is not as simple and innocuous as advertised. Serious complications may occur. Moreover, optimal buttock contouring entails not only volume augmentation but also volume removal; thus, volume augmentation with soft tissue fillers may not be ideal. Popularizing this modality must also be approached with great care. Serious complications do occur; they become inevitable when performed illegally by non-specialized, non-authorized, and unscrupulous practitioners in non-accredited facilities. Patients must be warned that adherence to regulations is critical and that only well-trained certified experts practicing legally in accredited facilities can address safely and efficiently their concerns. LEVEL OF EVIDENCE III 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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Affiliation(s)
- Bishara Atiyeh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Ghieh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Oneisi
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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3
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Nguyen TV, Nguyen TT, Vo NQ, Hoang NT, Le TB, Le HP, Ngo DHA. Complicated breast augmentation via self-injection of ultrasound gel and shoe glue: A case report. Radiol Case Rep 2022; 18:794-798. [PMID: 36582757 PMCID: PMC9793175 DOI: 10.1016/j.radcr.2022.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
Various types of dermal fillers have been developing for soft tissue augmentation. Even though many fillers have been approved and strictly regulated by authorities, homemade products for body contouring procedures are widely available and easily purchased on websites without prescriptions. It is challenging for radiologists to interpret radiological findings of complicated breast augmentation of unknown origin. While ultrasound is the modality of choice for initial work-up, magnetic resonance imaging (MRI) plays a role as the gold standard in evaluating the integrity of prosthetic implants. Using silicone or water-only MRI sequences may also be able to distinguish them. We report a rare case of breast abscess of a young female patient after self-injection of the mixture of ultrasound gel and shoe glue. The clinical and imaging aspect, especially MRI imaging, will be discussed.
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Affiliation(s)
- Thao Van Nguyen
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam
| | - Thanh Thao Nguyen
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam
| | - Nhu Quynh Vo
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam
| | - Ngoc Thanh Hoang
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam
| | - Trong Binh Le
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam
| | - Hong Phuc Le
- Department of Surgery, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Dac Hong An Ngo
- Department of Radiology, University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen st., Hue city, Thua Thien Hue 530000, Vietnam,Corresponding author.
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4
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Pérez Tristán FA, Pérez-Rocha F, Pérez Tristán C, Tamariz Campillo AF, Cuevas Bustos RA, Castillo De la Rosa MF, Jafif Cojab M. Foreign modeling agent reaction; managed with two staged surgical reconstruction. Case report and review of literature. Int J Surg Case Rep 2021; 84:106137. [PMID: 34237687 PMCID: PMC8264599 DOI: 10.1016/j.ijscr.2021.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction In Mexico, body modeling with injectable biomaterials such as liquid silicone is a common practice in non-certified clinics by non-medical personnel; These materials produces a series of complications described as Foreign modeling agent reaction (FMAR) with variable spectrum of severity. Case presentation 38-year-old female with history of biomaterial injection in a non-certified cosmetic clinic 10 years prior to evaluation. Presents with intermittent symptoms characterized by fever, erythema, induration and pain in the gluteal region. An exhaustive debridement and resection with primary closure was performed. Thereafter, reconstruction was done using a combined technique with gluteal implants and autologous fat graft, evolving without complications. Discussion The use of biomaterials has been widely documented throughout history; liquid silicone being one of the protagonists. Used for aesthetic purposes and modeling areas such as buttocks and breasts. They have been associated with an assortment of early or late onset complications, sometimes resulting in fatal outcomes. Various treatment modalities have been described depending on the severity of presentation, from conservative to surgical management. Conclusion There is a shortage of treatment guidelines regarding FMAR due to its wide variety of presentation, treatment must be individualized to obtain adequate results. Although conservative treatment has shown good results, the anatomical alterations usually condition dissatisfaction that should be addressed with reconstructive techniques [10]. Body modeling with injectable biomaterials such as liquid silicone is a common practice in non-certified clinics by non-medical personnel. FMAR is characterized by local and systemic alterations, most patients have continuous manifestations since diagnosis. There is a shortage of treatment guidelines regarding FMAR due to its wide variety of presentation.
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5
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Montrief T, Bornstein K, Ramzy M, Koyfman A, Long BJ. Plastic Surgery Complications: A Review for Emergency Clinicians. West J Emerg Med 2020; 21:179-189. [PMID: 33207164 PMCID: PMC7673892 DOI: 10.5811/westjem.2020.6.46415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/11/2020] [Indexed: 12/04/2022] Open
Abstract
The number of aesthetic surgical procedures performed in the United States is increasing rapidly. Over 1.5 million surgical procedures and over three million nonsurgical procedures were performed in 2015 alone. Of these, the most common procedures included surgeries of the breast and abdominal wall, specifically implants, liposuction, and subcutaneous injections. Emergency clinicians may be tasked with the management of postoperative complications of cosmetic surgeries including postoperative infections, thromboembolic events, skin necrosis, hemorrhage, pulmonary edema, fat embolism syndrome, bowel cavity perforation, intra-abdominal injury, local seroma formation, and local anesthetic systemic toxicity. This review provides several guiding principles for management of acute complications. Understanding these complications and approach to their management is essential to optimizing patient care.
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Affiliation(s)
- Tim Montrief
- University of Miami Miller School of Medicine, Department of Emergency Medicine, Miami, Florida
| | - Kasha Bornstein
- University of Miami Miller School of Medicine, Miami, Florida
| | - Mark Ramzy
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas
| | - Brit J Long
- Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas
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6
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Bejarano A, Bautista DF, Sua LF, Pérez B, Lores J, Aguirre M, Fernández-Trujillo L. Acute pneumonitis and diffuse alveolar hemorrhage secondary to silicone embolism: A case report. Medicine (Baltimore) 2020; 99:e20578. [PMID: 32541486 PMCID: PMC7302641 DOI: 10.1097/md.0000000000020578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Polydimethylsiloxane, commonly referred as silicone, is an inert liquid compound used in esthetic procedures due to its durability and thermal stability, yet the application of non-pure silicone generates risks. One of the complications is systemic embolism syndrome which is presents with fever, hypoxemia, and progression to respiratory failure, diffuse alveolar damage and alveolar hemorrhage, as well as neurological alterations in one-third of the cases. Management is strictly supportive. We present the case of acute pneumonitis with alveolar hemorrhage after silicone injection. PATIENT CONCERNS 25-year-old transsexual man, who consulted 48 hours after liquid silicone injection in the buttocks and trochanteric area, with progressive dyspnea and chest tightness, with rapid progression to respiratory failure. DIAGNOSIS Clinical diagnosis of silicone embolism was made. Chest x-ray and CT angiography showed diffuse alveolar infiltrates and pleural effusion without evidence of acute venous thromboembolism. Bronchoscopy plus bronchoalveolar lavage showed hemorrhagic fluid, 60% macrophages with hemosiderin in cytology and negative cultures. INTERVENTION Sedation, relaxation, pronation, and protective ventilation were implemented until hemodynamic stabilization; as well as IV steroids and antibiotics. OUTCOMES Clinical progress was slow towards improvement with resolution of radiological or physical abnormalities. Despite severity, the patient improved satisfactorily without late sequelae. LESSONS Silicone injection can trigger phenomena similar to that seen in fat embolism causing inflammation and immune response activation that lead to alveolar hemorrhage, diffuse alveolar damage, and acute respiratory distress syndrome. We reported pulmonary complications related to the illegal use of injected silicone for esthetic procedures.
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Affiliation(s)
| | - Diego F. Bautista
- Department of Critical Care Medicine
- Faculty of Health Sciences, Universidad Icesi
| | - Luz F. Sua
- Faculty of Health Sciences, Universidad Icesi
- Department of Pathology and Laboratory Medicine
| | - Bladimir Pérez
- Faculty of Health Sciences, Universidad Icesi
- Department of Pathology and Laboratory Medicine
| | | | | | - Liliana Fernández-Trujillo
- Faculty of Health Sciences, Universidad Icesi
- Department of Internal Medicine, Pulmonology Service, Interventional Pulmonology, Fundación Valle del Lili, Cali, Colombia
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7
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Chen YC, Lee JYY. Extensive disfiguring silicone granuloma of the face successfully treated with corticosteroid and doxycycline. Int J Dermatol 2019; 58:e217-e219. [PMID: 31281961 DOI: 10.1111/ijd.14576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 06/01/2019] [Accepted: 06/10/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Yu-Chen Chen
- Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Julia Yu-Yun Lee
- Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
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8
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Yeung H, Luk KM, Chen SC, Ginsberg BA, Katz KA. Dermatologic care for lesbian, gay, bisexual, and transgender persons: Epidemiology, screening, and disease prevention. J Am Acad Dermatol 2019; 80:591-602. [PMID: 30744875 PMCID: PMC6375301 DOI: 10.1016/j.jaad.2018.02.045] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal therapy and gender-affirming surgery. Familiarity with LGBT health issues and disease-prevention guidelines can enable dermatologists to provide medically appropriate and culturally competent care to LGBT persons.
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Affiliation(s)
- Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
| | - Kevin M Luk
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Division of Dermatology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Brian A Ginsberg
- Department of Dermatology, Mount Sinai Hospital, New York, New York
| | - Kenneth A Katz
- Department of Dermatology, Kaiser Permanente, San Francisco, California
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9
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Gillard M, Archier E, Monnet O, Souteyrand A, Turner F, Gras R, Quiles-Tsimaratos N. [Cutaneous foreign body granulomas following cervico-facial arterial embolization: Three cases]. Ann Dermatol Venereol 2018; 145:659-664. [PMID: 30217682 DOI: 10.1016/j.annder.2018.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/08/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Foreign body granuloma is an inflammatory tissue reaction to exogenous material. Classically it appears on the face after aesthetic procedures. Herein we report for the first time three cases of facial granulomatous reactions to microbeads after arterial cervico-facial embolization. PATIENTS AND METHODS Three patients underwent embolization of the facial arteries using Embogold® microbeads in a setting of epistaxis or tumoral hemostasis. Within 10 to 45 days painful, inflammatory, subcutaneous nodules appeared on the homolateral side of the face. Histological samples showed an inflammatory response with giant cells as well as the presence of microbeads in the skin. A favorable outcome was achieved with colchicine in one patient and with surgery in another; the third patient was lost to follow-up. DISCUSSION The embolizing microspheres produced a local inflammatory reaction, with destruction of the vascular wall and bead migration to facial tissue leading to a granulomatous reaction. The occurrence of three cases within a period of few weeks, with several different operators and batches of products, is surprising considering the long-standing use of the product. There was no common comorbidity in the patients and no suggestion of trauma. Retrospective analysis of the product batches was normal. Gold staining could play a role in severe inflammatory response to Embogold® particles. CONCLUSION These three cases illustrate the value of discussing potential foreign body granulomatous reaction in cases of facial nodules following cervico-facial embolization. Colchicine may offer a valuable therapeutic alternative.
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Affiliation(s)
- M Gillard
- Service de dermatologie, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France.
| | - E Archier
- Service de dermatologie, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
| | - O Monnet
- Service de radiologie interventionnelle, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
| | - A Souteyrand
- Service de dermatologie, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
| | - F Turner
- Service de chirurgie ORL, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
| | - R Gras
- Service de chirurgie ORL, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
| | - N Quiles-Tsimaratos
- Service de dermatologie, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille, France
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10
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Chen TA, Mercado CL, Topping KL, Erickson BP, Cockerham KP, Kossler AL. Disseminated silicone granulomatosis in the face and orbit. Am J Ophthalmol Case Rep 2018; 10:32-34. [PMID: 29780909 PMCID: PMC5956674 DOI: 10.1016/j.ajoc.2018.01.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/13/2018] [Accepted: 01/19/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose To report a case of disseminated silicone granulomatosis presenting with ptosis, proptosis and vision loss. Observations A 56-year-old female presented with ptosis, proptosis, and vision loss and was noted to have palpable, erythematous masses involving the orbit, face, trunk, and body. She had a history of bilateral silicone breast implants and cosmetic facial filler injections. Orbital biopsy demonstrated non-caseating granulomas with foreign-body giant cells and vacuoles containing material consistent with silicone. Removal of the patient's breast implants and systemic immunosuppression led to dramatic granuloma regression. Conclusions Silicone can induce a severe, systemic inflammatory response and should be considered in the differential for facial and periorbital granulomas in patients with a history of silicone breast implants. Management of disseminated silicone granulomatosis is challenging and requires multimodal treatment with silicone removal and systemic immunomodulation.
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Affiliation(s)
- Tiffany A Chen
- Stanford University, School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
| | - Carmel L Mercado
- Stanford Health Care, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94303, USA
| | - Katie L Topping
- Stanford Health Care, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94303, USA
| | - Benjamin P Erickson
- Stanford Health Care, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94303, USA
| | - Kimberly P Cockerham
- Veterans Administration Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Andrea L Kossler
- Stanford Health Care, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94303, USA
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11
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Lin DJ, Wong TT, Ciavarra GA, Kazam JK. Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants. Radiographics 2017; 37:2145-2163. [DOI: 10.1148/rg.2017170090] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Dana J. Lin
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032 (D.J.L., T.T.W., J.K.K.); and the Department of Radiology, NYU Langone Medical Center–Hospital for Joint Diseases, New York, NY (G.A.C.)
| | - Tony T. Wong
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032 (D.J.L., T.T.W., J.K.K.); and the Department of Radiology, NYU Langone Medical Center–Hospital for Joint Diseases, New York, NY (G.A.C.)
| | - Gina A. Ciavarra
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032 (D.J.L., T.T.W., J.K.K.); and the Department of Radiology, NYU Langone Medical Center–Hospital for Joint Diseases, New York, NY (G.A.C.)
| | - Jonathan K. Kazam
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032 (D.J.L., T.T.W., J.K.K.); and the Department of Radiology, NYU Langone Medical Center–Hospital for Joint Diseases, New York, NY (G.A.C.)
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12
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Antonelli RQ, Calderoni DR, Garcia IF, Stelini RF, Fregonesi A, Kharmandayan P. Liquid silicone used for esthetic purposes as a potentiator for occurrence of post-radiotherapy genital lymphedema: case report. SAO PAULO MED J 2017; 135:185-189. [PMID: 28538870 PMCID: PMC9977334 DOI: 10.1590/1516-3180.2016.0275251016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 10/25/2016] [Indexed: 11/21/2022] Open
Abstract
CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.
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Affiliation(s)
- Raíssa Quaiatti Antonelli
- MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.
| | - Davi Reis Calderoni
- MD, PhD. Attending Physician. Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Igor Ferreira Garcia
- MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.
| | - Rafael Fantelli Stelini
- MD. Attending Physician, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.
| | - Adriano Fregonesi
- MD, PhD. Attending Physician, Division of Urology, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.
| | - Paulo Kharmandayan
- MD, PhD. Associate Professor, Head of the Division of Plastic Surgery, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.
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13
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Silicone-induced Granuloma After Buttock Augmentation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e624. [PMID: 27014553 PMCID: PMC4778895 DOI: 10.1097/gox.0000000000000618] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/13/2016] [Indexed: 11/26/2022]
Abstract
Liquid silicone is inexpensive, minimally antigenic, and likely noncarcinogenic. Its simplicity of use has made it popular as a soft-tissue filler in some parts of the world for patients seeking rapid soft-tissue augmentation of the face, breast, and buttocks. However, multiple reports describe the complications of silicone injections such as cellulitis, abscess, ulceration, and foreign body migration. We present an unusual complication of granulomatous reaction secondary to silicone injection for buttock augmentation, with a literature review of this entity and treatment options. Our patient was a 54-year-old woman who underwent bilateral buttock augmentation in the Dominican Republic using percutaneous injection of liquid silicone. She presented to our facility 1 year after this procedure with pain and inflammation of both buttocks. She was diagnosed with multiple silicone granulomas. Her symptoms completely resolved with a 3-week course of minocycline. Granulomatous reactions to silicone may occur months to years after the silicone injection. The incidence of such complications may be increased when nonmedical-grade silicone is used, and hence, when these procedures are performed in developing countries. Tetracycline antibiotics, especially minocycline, may be used to achieve sustained remission.
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