Filler Migration and Granuloma Formation After Gluteal Augmentation with Free-silicone Injections

Abstract

Gluteal augmentation may be performed using a variety of techniques, including implant-based, autologous fat grafting, local flaps, impermanent filler injection, or, as in this case, by way of permanent filler injection with free-silicone. Of these, free-silicone injections carry one of the highest complication rates, specifically regarding migration of the filler material from the native injection site and induction of painful reactive soft tissue changes at the new filler location. A radiologist providing this diagnosis may assist the clinician, who often cannot obtain a history of illicit silicone injection for gluteal augmentation unless the suspicion is raised. Presented here is a case of painful filler migration to the knee with granuloma formation after free-silicone gluteal injection.

Free Silicone Injections to the Breast: Delayed Complications and Surgical Management of Sequelae

“… 2 , 5 Serious complications such as granuloma formation, migration, nodules, cystic lesions, chronic cellulitis, pneumonitis, emboli, and death have also been reported. 4 – 9 These severe complications can often be attributed to the use of unregulated, intentionally altered, or contaminated silicone injected in large volumes by non-medical personnel in non-clinical settings. 2 When purified, medical grade silicone is injected by experienced and licensed physicians using the microdroplet technique, complications are notably reduced—approximately 3%.…”

The Benign Side of the Abdominal Wall: A Pictorial Review of Non-Neoplastic Diseases

“…Free silicone and paraffin injections are dangerous beauty techniques, disused but still performed illegally [ 37 ]. Serious reactions to silicone injections have been reported, occurring 3 weeks to 23 years after treatment.…”

“…Serious reactions to silicone injections have been reported, occurring 3 weeks to 23 years after treatment. Aftermaths include strong pain, skin lesions, deformities, recurrent cellulitis and abscesses, granulomas (“siliconoma” and “paraffinoma”) in the subcutaneous and muscular tissue, lymphadenopathy, silicone migration, and necrosis [ 37 , 38 , 39 ]. Systemic complications have also been reported, including acute pneumonitis, granulomatous hepatitis, organ compression, and sudden death secondary to intravascular embolization [ 40 ].…”

“…On US, they are heterogeneously echoic, with marked posterior acoustic shadowing [ 39 ]. On CT, their diffuse infiltrating appearance is well seen, with solid density but a lack of contrast uptake, accompanied by fat stranding [ 37 , 38 ] ( Figure 13 ).…”

Injectable fillers: imaging features and related complications

“…Complications noted in this study were asymmetry, infection with cellulitis and abscess formation, migration, and scarring. Leyva et al [12] published a case of gluteal granuloma formation following gluteal augmentation with liquid silicon.…”