The 30-year-old woman arrived at the Henry Ford Hospital emergency room in Detroit out of breath and coughing blood.
It didn't take long for doctors to figure out why. The woman admitted to having been at a party at a hotel five days prior at which she – and others – received injections of liquid silicone to "enhance" the buttocks and various body parts.
The silicone was not the medical silicone that is sometimes used for implants, but the type easily procured at hardware stores like Home Depot.
Clots in the lungs
The fat solvent used to make the silicone had quickly travelled to her lungs and gotten stuck in the airways, resulting in "silicone embolism syndrome" or clots in the smaller vessels in her lungs.
The syndrome, admittedly rare, was first seen in transsexual men wanting to augment their breasts in the 1970s.
"There are two types of side effects [that can result from silicone injections]," said Dr Angel Coz, the pulmonary and critical care specialist who treated the woman. "Lungs is one of them. The other goes to the brain. The mortality in lungs is close to 20% but in the brain it's close to 100 percent."
This woman, who was attempting to augment her buttocks, was one of the lucky ones. She survived after receiving steroids, said Coz, who is slated to present information on the case at the American College of Chest Physicians' annual meeting in Honolulu.
Some have died
"We've been hearing about this," said Dr Malcolm Z. Roth, president of the American Society of Plastic Surgeons. "There are 'pumping parties,' involving high-volume injections to fill up the face, lips, cheekbones, chin or breast. Often it's buttock enhancement and often it's not sterile."
And these illicit procedures may be on the rise, thanks to a slow economy and pocketbooks that aren't full enough to afford incensed plastic surgeons, said Roth, who is also chief of plastic surgery at the Albany Medical Center in New York.
"It's really a white-coat deception," Roth said. "Sometimes the person doing the injections claims to be a physician from another country and in some cases the patient knows very well it's not a physician but, feeling they can't afford to go to a legitimate board-certified plastic surgeon, they find a short cut."
Two other, similar cases of patients developing complications after silicone injections are also being presented at the meeting this week.
One involved a 22-year-old woman who showed up at the UCLA Medical Center emergency room, also with shortness of breath. This quickly progressed to right ventricular failure of the heart and the patient died despite the physicians' best efforts.
Silicone and solvent
Most likely, the silicone and solvent had damaged the lungs, leading to collapse of the heart.
This patient had had injections in her buttocks from "a doctor in Mexico" earlier that day, a friend told doctors.
The researchers presenting the case said this is the first documented case of right ventricular failure from silicone injections.
The third case was a 23-year-old woman with the familiar symptoms, shortness of breath and cough, who had had several silicone injections in her buttocks.
She was diagnosed with silicone embolism syndrome but, after receiving oxygen and steroids and spending five days in the hospital, recovered and went home.
According to Roth, patients should "run away from these procedures".
"You don't do medical procedures in a hotel room or garage. This procedure is illegal," he said. "Patients need to do their homework and check the credentials of the professional they're considering for their cosmetic procedure."
"This is something that is not done by doctors," added Coz. "It's completely out of the realm of what any physician would do."
(HealthDay, Amanda Gardner, October 2011)