CHICAGO, Nov. 29 /PRNewswire/ -- Liquid silicone, which is often used
for breast augmentation and other cosmetic procedures, can cause
respiratory failure if not injected properly by a licensed physician. A
study of individuals who underwent illegal silicone injections revealed a
high fatality rate from pulmonary silicone embolism, or obstruction of the
lungs. The study was presented today at the annual meeting of the
Radiological Society of North America (RSNA).
"The illegal use of fluid silicone is a practice that carries life-
threatening risks, and the community should be aware of the complications,"
said Carlos S. Restrepo, M.D., director of chest radiology at the
University of Texas Health Science Center, San Antonio.
Dr. Restrepo and colleagues compiled the imaging findings of 44
patients with pulmonary embolism that resulted from illegal silicone
injection, constituting the largest case series to date.
Seven patients who presented to the hospital with respiratory distress
due to illicit silicone injection were studied, along with an additional 37
cases from the literature. Patients' demographic information, clinical
presentation, imaging findings and outcome were analyzed.
"Twenty-five of the patients were transsexual males, and 19 were
females," Dr. Restrepo said. "The most common sites of injection were the
breast, hips, buttocks, vagina, chest and arms."
All 44 patients experienced respiratory difficulties after receiving
the injections, and nearly half experienced fever. One-quarter of the
patients died from resultant bleeding in the lungs.
Silicone that is injected improperly travels through the bloodstream
and causes blood to coagulate in the lungs, creating circulatory
obstructions that can be immediately life-threatening if not identified and
treated quickly. The imaging findings of pulmonary silicone embolism
include dark, hazy patches in the lung tissue on x-rays or computed
tomography (CT) scans.
"Transsexual males in particular should be checked closely for signs of
pulmonary embolism when they show symptoms of respiratory distress and
fever," Dr. Restrepo emphasized. Male transsexuals often undergo cosmetic
procedures of the breasts, genitalia and other areas to make them appear
more feminine.
The U.S. Food and Drug Administration banned silicone injections in
1992, but people still seek them out because they are cheaper and easier to
get than professional plastic surgery or hormone therapy and provide
immediate results. In surgical clinics, transgender patients are often
required to undergo psychological testing before receiving treatment.
Unfortunately, the illicit nature of the injections makes it hard to
estimate how common they actually are. However, the increasing popularity
of the "pumping party" -- where a host will inject a number of people with
silicone in the same sitting -- indicates both the demand and the ready
availability of the substance.
Dr. Restrepo expressed the difficulties of conducting long-term
follow-up with patients who present with these complications, because of
the underground nature of the practice. It is hoped, he said, that by
making the public and the medical community aware of the symptoms and
severe consequences of illegal silicone use, mortality risks and patient
outcomes from this clandestine practice will improve.
Co-authors are Santiago Martinez-Jimenez, M.D., Jorge Carrillo, Aura L.
Rivera and Santiago E. Rossi, M.D.
AT A GLANCE
-- Liquid silicone can cause respiratory failure if injected improperly.
-- Transsexual males constitute the most at-risk population for
complications of illicit cosmetic silicone injections.
-- Patients with respiratory symptoms who are suspected of having received
illicit silicone injections should be examined immediately for
pulmonary embolism.
RSNA is an association of more than 40,000 radiologists, radiation
oncologists, medical physicists and related scientists committed to
promoting excellence in radiology through education and by fostering
research, with the ultimate goal of improving patient care. The Society is
based in Oak Brook, Ill.
SOURCE Radiological Society of North America
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CONTACT:
RSNA Newsroom, +1-312-949-3233, Before
11-25-06 or after 11-30-06: RSNA Media Relations,
+1-630-590-7762, or Maureen Morley, +1-630-590-7754,
mmorley@rsna.org
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