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The Pathology of Adulterated Injected Cosmetic Filler Materials
Author(s) -
Pulitzer M.,
Tan J.,
Levitt J.,
Phelps R.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320fs.x
Subject(s) - buttocks , medicine , silicone , dermatology , hyperpigmentation , granulation tissue , biopsy , surgery , pathology , wound healing , chemistry , organic chemistry
We report five cases of illicit injections of filler‐substances for cosmetic purposes in non‐medical clinics. The first two patients, a mother and 30‐year‐old daughter, presented with skin lesions in both legs after calf‐augmentation by paraffin injection 4 years prior. One week later calf hyperpigmentation and induration developed, with progression up the legs, and eventual purulent draining ulceration (daughter). The third patient, a 34‐year‐old female, presented with pink‐brown macules on both buttocks after receiving silicone injections 9 months earlier. The fourth patient, a 31‐year‐old female, developed skin lesions on the buttocks after silicone injections. The fifth patient, a 43‐year‐old female, developed sclerodermoid plaques on the buttocks after silicone injection. The first two biopsies showed large spaces in tissue, calcinosis cutis, dermal sclerosis, granulation tissue, and lymphedema. The third biopsy revealed foreign body reaction to non‐polarizing material, the fourth lipogranulomatous reaction, and the fifth microvacuolar change with scar. Biopsies post‐injection of cosmetic filler materials typically show macrovacuolar “swiss cheese” changes, and later microvacuolar changes with considerable granulomatous reaction. The reactions here were clinically severe, and may reflect adulteration of injected materials. We believe these cases augur a public health epidemic given a proliferation of non‐medical cosmetic “mills” which offer illicit cosmetic procedures.