Silicone pneumonitis after gluteal filler: a case report and literature review

Abstract

Liquid silicone (polydimethylsiloxane) is an inert material that is commonly used for cosmetic purpose. Silicone embolization syndrome (SES) can rapidly progress to pneumonitis as a consequence of the injection of nonmedical-grade liquid silicone. We describe a case of severe silicone pneumonitis complicated with acute respiratory distress syndrome and bilateral pneumothorax secondary to silicone gluteal augmentation. In this case report, we aim to discuss our experience and approach in managing an uncommon case of SES.

A hypoxic young lady in an acute confusional state

“…The pathogenesis of filler embolism syndrome (silicone or HA) remains elusive with two main theories being postulated: mechanical obstruction and biochemical injury [7,[14][15][16]. The mechanical obstruction mechanism was postulated to be due to direct injection of filler materials into microvasculature leading to micro-emboli in the venous capillaries, which then eventually lodged in the pulmonary vasculature bed leading to acute respiratory failure (i.e.…”

Compromiso del parénquima pulmonar secundaria a la inyección subcutánea de geles de silicona: reporte de caso

“…De acuerdo con la literatura, las edades de los casos varían entre los 20 a 55 años, y se presentan con mayor frecuencia en el sexo femenino; en menor cuantía, en los varones transexuales. Respecto a la clínica de presentación, va desde dificultad respiratoria, dolor torácico de tipo punzante u opresivo, fiebre, tos seca (1,5,(7)(8)(9)(10)11,12,13) y hemoptisis (14) ; así mismo, la presentación puede ser aguda, dentro de las primeras 24 horas tras la inyección, y latente, en donde se reportan casos de hasta 13 meses. La cantidad de geles de silicona inyectada repercute en el inicio de los síntomas, y se describe que desde 100 ml de inóculo a más puede presentarse en forma aguda (4) .…”

A Rare Case of Pulmonary Restrictive Syndrome after Liquid Silicone Injection: The Role of the Plastic Surgeon

“…7 Respiratory symptoms are present within 72 hours after injection of higher dose silicone, but a delayed reaction is normally described up to a year and a half after injection. 5 In this scenario, the release of silicone emboli leads to occlusion of the microvasculature and triggers the inflammatory response, resulting in pulmonary edema, hemorrhage, and subsequent fibrosis. Diagnosis of pneumonitis due to silicone liquid injection can be challenging due to a lack of an available specific algorithm and more diagnostic procedures are usually A Rare Case of Pulmonary Restrictive Syndrome after Liquid Silicone Injection Bonfirraro et al…”

“…The migration of silicone can reach the lungs with a picture of parenchymal siliconosis. 4,5 This complication can occur both in acute form with embolic modality and acute respiratory distress syndrome, 5,6 or chronically. 7 Respiratory symptoms are present within 72 hours after injection of higher dose silicone, but a delayed reaction is normally described up to a year and a half after injection.…”