Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia

  • William F. Amaya-Zúñiga a. Department of Anesthesia and Perioperative Medicine, Hospital Universitario Fundación Santa Fe de Bogotá. Bogotá, Colombia. b. Universidad de los Andes. Bogotá, Colombia. c. Universidad El Bosque. Bogotá, Colombia. https://orcid.org/0000-0003-0184-1752
  • Viviana Mojica-Manrique Department of Anesthesia and Perioperative Medicine, Hospital Universitario Fundación Santa Fe de Bogotá. Bogotá, Colombia. https://orcid.org/0000-0001-9646-1140
  • Iván Santos-Gutiérrez a. Department of Plastic Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. b. Colombian Society of Plastic Surgery. Bogotá, Colombia. c. International Society Aesthetic Plastic. Bogotá, Colombia. https://orcid.org/0000-0002-7220-1050
  • Julia Alfonso-Jaimes a. Department of Plastic Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. b. Colombian Society of Plastic Surgery. Bogotá, Colombia. https://orcid.org/0000-0001-7237-0834
Keywords: Silicone injection, Silicone migration, Regional anesthesia, Patient safety, Anesthesia

Abstract

The illegal use of liquid silicone products or biopolymers in gluteal augmentation procedures is giving rise to multiple complications, with a significant negative health impact, both in the short and long-term. The migration of polymers to the sacral and lumbar region represents a major limitation to conducting neuraxial anesthesia procedures. This silicon migration is unpredictable through the superficial tissue as is widely described in the literature. Caudal, spinal and epidural anesthesia may cross the silicone in the fascia and contaminate the neural axis with substances that are highly capable of causing inflammation, edema and tissue necrosis. In order to improve the safety of neuraxial anesthetic procedures and avoid the potential risk of dissemination and contamination of the neural axis, this complication must be ruled out, or be considered an emerging contraindication for these anesthetic procedures.

References

Narins RS, Beer K. Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential. Plast Reconstr Surg. 2006;118(3 Suppl):77S-84S. doi: http://www.doi.org/10.1097/01.prs.0000234919.25096.67

Leonardi NR, Compoginis JM, Luce EA. Illicit cosmetic silicone injection: A recent reiteration of history. Ann Plast Surg. 2016;77(4):485-90. doi: http://www.doi.org/10.1097/SAP.0000000000000756

Bertin C, Abbas R, Andrieu V, Michard F, Rioux C, Descamps V, et al. Illicit massive silicone injections always induce chronic and definitive silicone blood diffusion with dermatologic complications. Medicine (Baltimore). 2019;98(4):e14143. doi: http://www.doi.org/10.1097/MD.0000000000014143

FDA. Injectable silicone for body contouring and enhancement: FDA safety communication – FDA warns against use [internet]. 2017 [citado: 2017 nov, 14]. Disponible en: https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm584986.htm.

Rapkiewicz AV, Kenerson K, Hutchins KD, Garavan F, Lew EO, Shuman MJ. Fatal complications of aesthetic techniques: The gluteal region. J Forensic Sci. 2018;63(5):1406-12. doi: http://www.doi.org/10.1111/1556-4029.13761

Altmeyer MD, Anderson LL, Wang AR. Silicone migration and granuloma formation. J Cosmet Dermatol. 2009;8(2):92-7. doi: http://www.doi.org/10.1111/j.1473-2165.2009.00436.x

Chasan PE. The history of injectable silicone fluids for soft-tissue augmentation. Plast Reconstr Surg. 2007;120(7):2034-43. doi: http://www.doi.org/10.1097/01.prs.0000267580.92163.33

Barilaro G, Spaziani Testa C, Cacciani A, Donato G, Dimko M, Mariotti A. ASIA syndrome, calcinosis cutis and chronic kidney disease following silicone injections. A case-based review. Immunol Res. 2016;64(5-6):1142-9. doi: http://www.doi.org/10.1007/s12026-016-8871-1

Alahmari HS, Alarfaj AS, Aljohani TE. Retroperitoneal fibrosis after chronic abscesses of silicone fluid fillers in a case of gluteal augmentation. Case Rep Med. 2020;2020:7236295. doi: http://www.doi.org/10.1155/2020/7236295.

Leyva A, Tran T, Cibulas AT, et al. Filler migration and granuloma formation after gluteal augmentation with free-silicone injections. Cureus. 2018;10(9):e3294. doi: http://www.doi.org/10.7759/cureus.3294

Gold HL, Wang I, Meehan S, Sánchez M, Smith GP. Gluteal silicone injections leading to extensive filler migration with induration and arthralgia. Dermatol Online J. 2015;21(2).

Harker DB, Turrentine JE, Desai SR. Vulvar asymmetry due to silicone migration and granulomatous immune response following injection for buttock augmentation. J Clin Aesthet Dermatol. 2017;10(4):50-4.

How to Cite
1.
Amaya-Zúñiga WF, Mojica-Manrique V, Santos-Gutiérrez I, Alfonso-Jaimes J. Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia . Colomb. J. Anesthesiol. [Internet]. 2021Mar.25 [cited 2021Oct.25];49(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/977

Downloads

Download data is not yet available.
Published
2021-03-25
How to Cite
1.
Amaya-Zúñiga WF, Mojica-Manrique V, Santos-Gutiérrez I, Alfonso-Jaimes J. Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia . Colomb. J. Anesthesiol. [Internet]. 2021Mar.25 [cited 2021Oct.25];49(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/977
Section
Essay

More on this topic