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

This report concerns a 26-year-old male-to-female transsexual who had recei ved a large volume liquid silicone injection of unknown grade into her uppe r lateral thighs to gain female contour. She presented at our outpatient cl inic 4 years after the silicone injection with complaints of pain and silic one sagging down as far as both ankles. On physical examination a massively swollen right ankle with signs of inflammation was seen, On magnetic reson ance imaging (MRI), massive diffuse and localized silicone infiltration in the soft tissues of the entire lower limbs was seen. After conservative tre atment of the soft tissue infection, the first attempt to solve this proble m was excision of large solid infiltrates of silicone in combination with l iposuction. Liposuction was not able to reduce the silicone load. After a r ecurrent inflammation had subsided, radical subcutaneous debridement was pe rformed. 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 mon ths. It is concluded that, even now, large-volume silicone injections are p erformed, These procedures will end in disaster without exception. The trea tment of these disasters is complicated and never satisfactory.