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CTV News – Illicit silicone injections risky, even deadly: doctors

A syringe sits on an table at Rocky Mountain Primary Care's Thornton, Colo., location, Thursday, Oct. 26, 2006. (AP Photo/Jack Dempsey)

Date: Monday Oct. 24, 2011 7:23 AM ET

TORONTO — Doctors are warning consumers about the dangers of a backstreet cosmetic practice known as “pumping” or “plumping,” in which liquid silicone is injected into the buttocks or other body parts to enhance their size and shape.

Injections of even medically approved liquid silicone are rarely used by physicians because of the risk the substance will migrate into the bloodstream or other tissues.

But injecting large quantities of what is often commercial-grade silicone intended for home repair can lead to serious illness and even death.

In three case reports presented Sunday at the meeting of the American College of Chest Physicians, doctors said two women ended up in hospital with severe respiratory distress and another died after having their buttocks recontoured with liquid silicone.

One of the reports described the case of an otherwise healthy 30-year-old woman who was admitted to Henry Ford Hospital after having silicone injections to enlarge her buttocks.

“And she decided to have it done in a hotel room by God knows who,” said Dr. Angel Coz Yataco, a pulmonary medicine specialist at the Detroit hospital, who treated the patient and described the case to the meeting in Honolulu.

“He was supposedly some sort of nurse or somebody with experience, but we doubt that was the case,” Coz Yataco said in an interview.

“They grab this Home Depot silicone and they just inject, any type of retail, commercial silicone, not for any medical purposes,” he said.

Because such untrained practitioners are unlikely to know the proper technique for safely performing an intramuscular injection, there’s an even higher risk of the silicone entering one of the blood vessels “and then shooting into the lungs, and that’s what happened with this lady,” he said.

The woman began experiencing shortness of breath immediately after the injections, and her condition worsened over the next couple of days. After seeking help at the hospital’s emergency department, she started coughing up blood, Coz Yataco said.

Tests showed particles of silicone had lodged in her lungs and were causing severe inflammation, which was treated with steroids.

The woman recovered, as did a 23-year-old woman treated in New Orleans for lung inflammation after having silicone enhancement of her buttocks, whose case also was presented at the meeting. but a 22-year-old California woman reported on was not so fortunate: she died in hospital of a heart attack after having the butt-enlarging injections by “doctors from Mexico.”

Coz Yataco said the other most common reaction to the injections that doctors see is a stroke-like effect caused when silicone makes its way through the bloodstream into the brain, where the tiny globules produce blood clots.

“When it goes to the brain, the mortality is as high as 100 per cent,” he said.

His search of the medical literature turned up 110 cases of silicone in either the lungs or brain, leading to death in about 20 per cent of respiratory patients and virtually all of those whose brains were affected.

But the true extent of the illicit cosmetic procedure is likely far higher, he said. indeed, the lay press is rife with stories of people attending “plumping parties,” where both men and women have silicone injected into a wide variety of body parts — including as a means of enlarging the nerve- and blood-vessel-rich genitals.

Coz Yataco said the woman he treated was unaware of the dangers and explained she had been talked into having the buttock enlargement by a friend who had her behind plumped up on several occasions.

“And it’s in a hotel room and they do these sort of parties and several of them get injected,” he said, adding that between 10 and 20 people can be done at one time, each forking over hundreds of dollars each.

“People who do this illegally need to be stopped, because they are killing people … They’re just unlicensed people who decide to do this, they charge a lot of money and then people die.”

Toronto plastic surgeon Dr. Wayne Carman said injection of even medical-grade liquid silicone is not approved for cosmetic tissue enhancement, and in fact its authorized clinical use is extremely limited.

Recontouring the buttocks, for instance, can be done by certified plastic surgeons in a number of ways, including the use of encapsulated silicone implants — similar in concept to those used for breast enlargement or reconstruction.

While some plastic surgeons get what he calls a “nice result,” it is difficult to achieve symmetry with the implants, said Carman, a member of the Canadian Society for Aesthetic Plastic Surgery.

Instead, he favours a procedure in which fat is liposuctioned from one part of the patient’s body, then used to recontour the buttocks.

But the “whole concept of injectable silicone is to be discouraged,” he stressed.

“That (commercial) stuff is great for your house, but it’s got heavy metals in it, any number of other chemicals that are not compatible with your body, and some of them are probably poisonous. They’re quite toxic.”

<a href="http://www.ctv.ca/CTVNews/Health/20111024/silicone-injections-risks-111024/tag:news.google.com,2005:cluster=http://www.ctv.ca/CTVNews/Health/20111024/silicone-injections-risks-111024/Mon, 24 Oct 2011 11:27:29 GMT”>CTV News – Illicit silicone injections risky, even deadly: doctors

Dangers of cosmetic surgery overseas

By Montse Gil RivasPublished: 12:04PM BST 22 Feb 2011 the case of Claudia Adusei, a student at Thames Valley University who died in Philadelphia following an operation in which liquid silicone was injected into her buttocks in a procedure to enhance her bottom, highlights the risks of cosmetic surgery.

Annually, thousands of Britons travel overseas for medical treatment, particularly dental work and cosmetic surgery.

Degrees of plastic surgery vary

Some of us age with sags and bags around our eyes and necks. Others of us grow “hollow” with seemingly empty cheeks.

“People have had the same concerns for a hundred years and written about it,” says Dr. Val Lambros, a Newport Beach, Calif., plastic surgeon.

That means one of the most difficult decisions to make when considering cosmetic treatment is whether to undergo the knife or to get poked by a needle, he says. the difference is visible — on your face and in your wallet.

“Injectable fillers allow surgeons to improve one’s natural appearance by defining facial features or to correct post-surgical imperfections without having to spend thousands of dollars on your appearance,” he says. “But the results are not always noticeable.”

Lambros defined the choices:

— Fillers: An option for patients who prefer noninvasive treatment to look and feel refreshed. Shorter recovery time and lower cost.

— Surgery: Ideal when a patient wants to remove fat and skin or rearrange muscle.

— Hyaluronic acid, soft tissue, calcium hydroxylapatite gel and liquid silicone have been used to enhance facial features or correct facial imperfections. Silicone is not generally recommended because of the risk of complications such as nodules, cellulitis and ulceration. Hyaluronic acid is cheapest and lasts up to three years.

Q: why do some people looked stretched and pulled?

A: be honest. some people look frightening. the funny thing is, they usually think they look great. Like Lindsay Lohan. why do they do it to their lips?

Q: do you do it?

A: I do it until I think it looks right and then no more.

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The point is, use all the tools at your disposal. Botox and Restylane help with crow’s feet and lines around the mouth. But you don’t need an operation for these problems. I know doctors who ask you to point to what bothers you, and then they operate.

When I refuse to operate, the patient actually should say, “Thanks for not taking advantage of me.”

Q: Sounds as if you are not proud of your compatriots.

A: unfortunately, too many are not in the doctoring business. Instead, they are in the beauty business.

If you are planning to have work done, see more than one board-certified plastic surgeon. Don’t rush. Pick reputable people.

Q: why do we think it’s being self-centered to get cosmetic work done?

A: if something bothers you, get it done. because to you, it is a problem.

A lot of times, however, I try to talk people out of surgery I don’t think is in their best interest. I’m kind of a puritan that way.

Q: about 12 years ago I had work done on my chin and my eyes. at that time, I had inherited the “Irish” chin and the “German” eyes, both genetic downfalls of my family.

I went to see three surgeons. one wanted to lift my eyebrows and do much more work to my eyes than I thought necessary. the second stood in the doorway of his office and looked at me sitting on the examining table and just shook his head. “Fortunately, I can correct the problem.”

The third, the late Dr. Bruce Achauer, said, “I can make you look the way you want to look and you will never want more work done.” He was right.

A: Dr. Achauer was one of my teachers. He was one of the best.

Q: I hear Orange County, Calif., has as many cosmetic surgeons as Beverly Hills.

A: And the funny thing is, the O.C. folks go to Beverly Hills and vice versa. the farthest away seems to be the best.

Q: are there more answers on your website?

A: Yes, www.vallambros.com

— — —

(Jane Glenn Haas writes for the Orange County (Calif.) Register. E-mail her at jghaas@cox.net)

Degrees of plastic surgery vary

Breast Augmentation, Liposuction, and Rhinoplasty

beverlyhillsplasticsurgery.com Breast implants may be used to either to create fuller breasts or to restore breasts that have lost volume due to weight loss or from pregnancy. Breast augmentation can increase the fullness and projection of your breasts, improve the balance and proportions of your figure and improve your self-image and self-confidence. according to the American Society of Plastic Surgeons, breast augmentation is the most commonly performed cosmetic surgical procedure in the United States. there are two primary types of breast implants saline-filled and silicone-gel-filled implants. Saline implants have a silicone elastomer shell filled with sterile saline liquid. Silicone gel implants have a silicone shell filled with a viscous silicone gel. Liposuction, also known as liposculpture, is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don’t respond to traditional weight-loss methods. Rhinoplasty, or nose surgery, can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. it may also correct a birth defect or injury, or help relieve some breathing problems. The best candidates for rhinoplasty

plasticsurgerybh.com Follow plastic surgery patient Megan from her first consult to final results as she has both Breast Augmentation and Liposuction performed by Beverly Hills plastic surgeon Dr. David Kim. Learn first hand what it’s like to undergo these procedures as she tells the story of her experience discussing everything from why she decided to have these procedures to the impact these procedures have had on her life. Produced by Spore Medical http for Beverly Hills Aesthetic Plastic Surgery www.beverlyhillsplasticsurgery.com

Related Plastic Liposuction Surgery Articles

Breast Augmentation, Liposuction, and Rhinoplasty

How safe is cosmetic surgery?

10 February 2011 Last updated at 09:11 ET Share this page by Sonya McGilchrist BBC News health reporter Cosmetic surgery procedures rose by 5% last year

Cosmetic surgery is becoming increasingly popular – there are now around 100,000 operations in the UK each year.

But for those tempted to improve their looks surgically, how safe are the procedures?

Claudia Adusei's tragic death in Philadelphia this week followed an operation using an unapproved substance.

Liquid silicone was injected into her buttocks in a procedure designed to enhance her bottom.

The operation is believed to have been arranged over the internet and took place at a hotel near Philadelphia International Airport.

But now that cosmetic surgery is becoming more common, are the risks associated with even standard procedures being under-estimated?

'Have-a-go' surgeons

Last September, a report by an official review body, the National Confidential Enquiry into Patient Outcome and Death found many centres in the UK offering cosmetic surgery were failing to assess and care for patients properly.

Patients were at risk from a culture which saw teams "have a go" at operations they rarely performed.

The report by the National Confidential Enquiry into Patient Outcome and Death looked at 361 sites in the UK. It found that some teams were too inexperienced to be offering some cosmetic procedures.

With the exception of breast enlargement operations, the majority of sites were not carrying out enough procedures to keep their skills up.

To be safe, sites should be carrying out more than 20 operations a year – in order to give them enough experience.

But only a fifth had managed this for breast reductions and a quarter for facelift.

Other problems identified by the report included psychological evaluations often not being carried out, and more than half of the operating theatres not being properly equipped.

Monitoring before and after treatment was also not sufficient in many cases.

Regulation

Last October, the Care Quality Commission (CQC) was put in charge of regulating the cosmetic surgery industry in England.

All independent clinics and hospitals that provide cosmetic surgery must be licensed with the CQC to provide services.

A spokeswoman for the CQC said that even with enhanced regulation, patients should take care.

"Cosmetic surgery of any sort should not be undertaken lightly. It's important to remember that all surgery, including cosmetic procedures, involves risks."

She advised would-be patients to find out as much as they can about the provider and the procedure.

The CQC now has the powers to fine and prosecute cosmetic surgery centres that are not up to standard and gives advice on its website for people considering cosmetic surgery.

Plastic surgeons should also be registered with the General Medical Council (GMC).

‘Trivialised’

The British Association of Aesthetic Plastic Surgeons (BAAPS) represents around a third of cosmetic surgeons in the UK.

Its president, Fazel Fatah, said that problems arose because of the attitude towards cosmetic surgery.

"It has become trivialised to the extent that people do not understand that they are having surgery – and undergoing the same risks as with any other operation."

He said that the boundaries between cosmetic medicine and cosmetic surgery had become blurred and that people now believed that cosmetic surgery was somehow simple.

However good surgeons should go through all the risks with any patient, and give them time to change their mind.

"Complications can include infection, bleeding, thrombosis and clotting of the veins," mr Fatah said. "A patient needs to weigh-up the benefits against the risks."

Some cosmetic surgical procedures are more risky than others. As with other surgery, longer operations that involve a general anaesthetic are more risky than those that need only a local anaesthetic.

A tummy-tuck is one of the surgical procedures which has higher complication rates because mobility is restricted after surgery.

The buttock augmentation procedure that Ms Adusei had is not very common in the UK, though there are some surgeons who perform the operation.

However, the liquid silicone with which she was injected is not used here as surgeons realised years ago that it could cause problems. Solid silicone implants are now used instead.

Cosmetic surgery 'holidays'

However, going abroad for treatment has become an increasingly popular option over the years as it can be cheaper.

But surgeons warned it could also be riskier.

A survey by BAAPS in 2009 found that a quarter of surgeons said they had seen an increase in the numbers of patients who had experienced complications stemming from cosmetic surgery "holidays".

The organisation advises anyone thinking of going for surgery abroad to think carefully and beware of internet sites offering to set up patients with surgeons.

Fazel Fatah said quality standards in the UK, set by the CQC were high, but this was not the case in all countries.

"If you go abroad for surgery it is much harder for you to research a surgeon's record or the safety of the hospital you will be visiting, even if they are members of that country's association of surgeons.

"Aftercare will also be much harder – it can take weeks, even months for someone who has had cosmetic surgery to realise that there is a problem. by that time they are back home again."



How safe is cosmetic surgery?