Abstract
[...]animal studies with subcutaneously injected medical-grade silicone have shown that it can subsequently be recovered in various organs.1, 2 Bilateral silicone implants in one patient resulted in high fever, diffuse arthritis, renal failure, and bilateral pulmonary infiltrates.3 Illicit injections of silicone in human beings have been associated with adverse effects, including migration of the silicone, granulomatous hepatitis, hypopigmentation, and an acute febrile systemic illness that led to death in one patient.4 Nevertheless, only a few patients have been reported to have adverse systemic effects after silicone injection. In Patients 2 and 3, ultrastructural examination of lung macrophages obtained by bronchoalveolar lavage disclosed prominent, pleomorphic inclusions; moreover, the presence of silicone in cells and supernatants from bronchoalveolar lavage was confirmed by atomic absorption and infrared spectrophotometry. [...]it is clear that silicone gained access to the bloodstream and formed an embolus in the lungs. Chemical analysis of the sample of oily liquid that we obtained from Patient 3 revealed that it was pure dimethicone. [...]even if it is difficult to exclude the possibility that a contaminant (another chemical product or a bacterial toxin) was involved in the transient pulmonary disorder, it is highly probable that the silicone acted as one of the primary factors. [...]there is ample evidence that silicone can evoke a foreign-body granulomatous response.1, 2, 9 10 11 Recently, spalled particles of silicone migrating from blood-pump tubing were observed in the livers of patients on long-term hemodialysis.12 13 14 The refractile particles of silicone were associated with various degrees of hepatic inflammation and fibrosis, and granulomatous hepatitis was evident in nine cases.14 On rare occasions,4 illicit subcutaneous injections of silicone have produced hepatic granulomas and an acute febrile systemic illness; in one case, large silicone-fluid injections under each breast resulted in acute, lethal pulmonary edema.