Silicone injections.

Scott Liu and Alan A. Lim report in this issue on deleterious adverse effects of silicon injections for female breast enhancement.[1]

Silicone oils (liquid silicone) have been used for decades as fillers and sculpturing agents. Silicone oils have been and are still used for soft tissue augmentation for a broad range of indications.[2] Proponents of silicone use argue that large-volume injections, industrial grade silicone and lay persons or unskilled medical staff are responsible for the negative appearance of liquid silicone.

However, there is no food and drug administration (FDA)-approved product available for soft tissue augmentation. The major indication for FDA-approved products is retinal detachment with the removal of the material after re-attachment. In soft tissue augmentation, the removal of silicone is impossible without surgery. The use of liquid silicon is off label.[3]

It is interesting to know that for decades, horrendous complications have been reported from silicone injections into breasts and its use has been banned by many authorities. Here both large-volume implementation and multiple small depots were used.[4] Severe adverse effects have also been noted after the use for facial tissue augmentation.[5-7] After illegal silicone injection, the silicone embolism syndrome has been observed with a potential fatal outcome in about one quarter of patients.[8]

Liu and Lim provide an excellent review on hazards and most severe complications after illegal breast enhancement with liquid silicone. The misconception of an easy and relatively cheap way to improve body sculpture can lead to disease and disaster. The authors demonstrate their way to support patients with silicone mastitis. A radical surgical removal of silicone and immediate breast reconstruction are the cornerstones of therapy. What they achieved is fascinating. However, the most important part is the strict avoidance of liquid silicone for body sculpturing.