Posterior Body Lift to Treat Chronic Infection Following Large Volume Industrial Silicone Injection

Introduction-

Silicone implants for gluteal augmentation have gained popularity in the last decade [1]. Once thought to be biologically inert, liquid silicone has been found to cause an inflammatory granulomatous effect of variable severity [2]. Multiple treatments have been reported for silicone granulomas including intralesional or systemic corticosteroids, long pulsed laser and local excision [3]. We present an interesting case of a complicated chronic gluteal wound following large volume industrial grade silicone injections. 

Case report-

An otherwise healthy 46 year old female presented to the emergency department with a large chronic draining wound after having undergone bilateral gluteal augmentation with large volume industrial grade silicone 3 years prior. Patient experienced multiple acute on chronic infections requiring multiple admissions and intravenous antibiotics following the procedure. Examination revealed diffuse chronic induration posteriorly between bilateral iliac crests and a 12 cm indurated, erythematous and tender region of the left lower buttock. Computed tomography revealed extensive subcutaneous edema and skin thickening int the lower lumbar and gluteal regions. 

Treatment-

Preoperative evaluation and discussion with the patient emphasized the goals of treatment, specifically to remove the chronic indurated tissue with intention to prevent future recurrence, to treat the active infection and to create aesthetically pleasing incisions. The patient was taken to the operating room for posterior body lift with resection of majority of the free silicone and excision of the lower active infection. The posterior body lift incision healed well and was easily hidden beneath lingerie. The left lower incision was allowed to heal by secondary intention with minimal scarring.

Conclusion-

The successful outcome highlights the importance of preoperative planning to provide our patient with a safe, reliable and aesthetically pleasing result.

References: 

1. Mofid, MM, Gonzalez R. Buttock augmentation with silicone implants: a multicenter survey review of 2226 patients. Plast Reconstr Surg. 2013 Apr;131(4):897-901. 

2. Camuzard O, Dumas P. Severe granulomatous reaction associated with hypercalcemia occurring after silicone soft tissue augmentation of the buttocks: a case report. Aesthetic Plast Surg. @014 Feb;38(1):95-9.

3. Altmeyer MD, Anderson LL. Silicone migration and granuloma formation. J Cosmet Dermatol. 2009 Jun;8(2):92-7.