Large volume liquid silicone injection in the upper thighs: a never ending story

Abstract 

This report concerns a 26-year-old male-to- female transsexual who had received a large volume liquid silicone injection of unknown grade into her upper lateral thighs to gain female contour. She presented at our outpatient clinic 4 years after the silicone injection with complaints of pain and silicone sagging down as far as both ankles. On physical examination a massively swollen right ankle with signs of inflammation was seen. On magnetic resonance imaging (MRI), massive diffuse and localized silicone infiltration in the soft tissues of the entire lower limbs was seen. After conservative treatment of the soft tissue infection, the first attempt to solve this problem was excision of large solid infiltrates of silicone in combination with liposuction. Liposuction was not able to reduce the silicone load. After a recurrent inflammation had subsided, radical subcutaneous debridement was performed. The local skin was used as a full-thickness skin graft. As of now, there has been no recurrence of pain and inflammation for the first 15 months. It is concluded that, even now, large-volume silicone injections are performed. These procedures will end in disaster without exception. The treatment of these disasters is complicated and never satisfactory.