Oil-Soluble Vitamins: Illegal Use for Lip Augmentation

Abstract

Fillers for lip augmentation have become more and more popular in recent years and seem to be indispensable in the cosmetic market nowadays. A series of six young females is presented who developed massive swellings and pain after vitamins A and/or E lip augmentation. The vitamins were extracted from gelatinous capsules (Gericaps [Adipharm EAD, Sofia, Bulgaria], Geritamins [Actavis EAD, Balkanpharma-Dubnitsa AD, Bulgaria], or vitamin E yellow gel capsules) and injected by unprofessional physicians and beauticians in different cosmetic centers. Physical examination revealed firm indurations of the lips and perioral skin, tenderness, erythema, and hard dermal nodules. Histological analysis revealed numerous round-to-ovoid cavities of varying sizes, resulting in a Swiss cheese-like appearance, consistent with lipogranulomas. The patients were treated with systemic and intralesional triamcinolone injections and broad-spectrum antibiotics with good clinical response. In conclusion, these cases demonstrate the danger of the use of unregistered products as fillers injected by unprofessional physicians and beauticians.

Facial lipogranulomas due to self-injection of vitamin A oil

“…Recently, Kamouna et al (2014) presented a case series of six women who developed firm dermal nodules, erythema, and pain after injection of vitamins A and/or E into their lips. Similar to our findings, a histopathologic analysis revealed numerous round-to-ovoid, vacuole-like cavities of varying sizes in the dermis that resulted in a Swiss cheese-like appearance consistent with a lipogranuloma (Kamouna et al, 2014). These cavities previously contained oily material that is lost during routine tissue processing.…”

Serious complication as a result of lip augmentation with vitamin E

“…Other therapies include bleomycin, minocycline, isotretinoin, azathioprine, cyclosporine, 5‐fluorouracil, calcineurin inhibitors, and imiquimod. Using intralesional 808‐nm diode laser light can lead to dissolution of organic and synthetic parts of granuloma and facilitate evacuation …”

“…Using intralesional 808-nm diode laser light can lead to dissolution of organic and synthetic parts of granuloma and facilitate evacuation. 3,7 In conclusion, injection of illegal materials for tissue augmentation may accompany serious adverse reactions, which can be challenging and difficult to treatment.…”

Adverse effects of fillers

“…Paraffin is irreversible and no longer legally used as a filler although highly inflammatory granulomas after fraudulent use of paraffin or other oils containing vitamin E, sometimes also D and A, are still seen (Kamouna et al, 2014). Injection of paraffin into the penis caused sclerosing lipogranuloma characterized by fibrosis and deformation (Foucar, Downing, & Gerber, 1983).…”