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.
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"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."