Illicit silicone injections can be lethal

NEW YORK, Dec 1 (Reuters) Illicit injections of liquid silicone for cosmetic purposes can be fatal, often leading to pulmonary embolism and severe respiratory failure, Dr Carlos S Restrepo told the Radiology Society of North America's annual meeting in Chicago where he shared imaging findings from a series of 44 patients.

In 1992, the US Food and Drug Administration banned direct injection of silicone, but the increasing popularity of so-called ''pumping parties'' where black market silicone is injected by untrained ''hosts'' into paying clients speaks to both the demand and availability of the substance, experts say.

Male transsexuals often undergo cosmetic procedures of the breasts, genitalia and other areas to make them appear more feminine. They may seek out liquid silicone because it is cheaper and easier to get than professional plastic surgery or hormone therapy and it provides immediate results.

But silicone that is injected improperly can travel through the bloodstream and cause blood to clump in the lungs, creating blockages that can be immediately life threatening if not identified and treated promptly.

Of the 44 patients in Restrepo's series the largest case series reported to date 25 patients were transsexual males and 19 were females.

All 44 patients experienced respiratory difficulties after receiving illicit liquid silicone injections and half developed fever. ''The mortality rate was 25 per cent,'' Restrepo, who is director of chest radiology at the University of Texas Health Science Center in San Antonio noted in an interview with Reuters Health.

Silicone was injected most often in the breast, hips, buttocks, vagina, chest and arms.

''It is difficult to really quantify how prevalent this practice is,'' Restrepo said, ''since patients usually do not disclose when they come to the ER with respiratory symptoms that they have received illicit injections of fluid silicone.'' Restrepo hopes that by making the public and medical community aware of the symptoms and severe consequences of illegal silicone use, mortality risks and patient outcomes from this clandestine practice will improve.

REUTERS SY ND0850