Local complications after industrial liquid silicone injection: case series.

OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5 ml to 2000 ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.

Complicações locais após a injeção de silicone líquido industrial: série de casos / Local complications after industrial liquid silicone injection: case series

OBJETIVO: analisar uma série de casos de pacientes submetidos à injeção de silicone líquido industrial de maneira clandestina e por pessoas não habilitadas. MÉTODOS: análise retrospectiva de prontuários de pacientes atendidos no período de setembro de 2003 a dezembro de 2010. Foram avaliados: sexo, idade, local e volume de silicone injetado, tempo decorrido entre a aplicação e as manifestações clínicas, complicações, tratamento e evolução. Definiu-se como precoce as manifestações ocorridas até 30 dias da injeção e manifestações tardias após este período. RESULTADOS: Foram atendidos 12 pacientes, oito eram do sexo masculino, sendo sete transexuais. O volume injetado variou de 5ml a 2000ml, sendo desconhecido em três casos. Os locais mais frequentemente utilizados para injeção foram a região de coxas e glúteos. Oito casos apresentaram manifestações precoces, com quadros de inflamação e/ou infecção. Foi necessária a realização de desbridamento cirúrgico em cinco casos. Três pacientes com histórico de injeção na região mamária foram submetidas à adenomastectomia. Houve um óbito por quadro de choque séptico refratário. CONCLUSÃO: O uso do silicone líquido industrial deve ser totalmente contraindicado como material de preenchimento e modificação do contorno corporal, podendo apresentar graves complicações e até mesmo óbito.

OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5ml to 2000ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.

Sutureless closure of the upper eyelids in blepharoplasty: use of octyl-2-cyanoacrylate.

BACKGROUND: Skin adhesives provide an alternative to sutures for skin closure. The use of octyl-2-cyanoacrylate in blepharoplasty has been reported by some authors, but difficulties in applying the product and the real benefits of its use are still controversial. OBJECTIVE: The purpose of this study is to show a simple technique for closing the upper incision in blepharoplasty with octyl-2-cyanoacrylate instead of sutures and to discuss its benefits. METHODS: Eight female patients who underwent blepharoplasty had the upper incision closed with octyl-2-cyanoacrylate, for a total of 16 eyelids studied. Temporary stitches were placed along the incision and pulled by traction to approximate the skin borders. After apposition of the skin borders, high viscosity octyl-2-cyanoacrylate (Dermabond; Johnson & Johnson, New Brunswick, NJ) was used to close the incision. The stitches were removed immediately after glue crust formation, leaving the incision without sutures. The procedure was timed and a Hollander wound scale was used to evaluate the aesthetic results. RESULTS: Approximation of the skin borders with temporary stitches made it easier to apply octyl-2-cianoacrylate. The average gap between the skin borders was 1.0 cm. No major complications were encountered, although minor wound dehiscence occurred in 2 eyelids (12.5%). The closure time averaged 6.9 minutes and the aesthetic results were considered very good or excellent. CONCLUSIONS: Closure of the upper eyelids using octyl-2-cianoacrylate and temporary stitches removed immediately after glue crust formation is a safe and easily reproduced technique, with no differences in aesthetic outcome compared with suture closure.