Pseudocyst of the neck after facial augmentation with liquid silicone injection. 2014

Hwan Jun Choi
From the Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea.

Injection of liquid silicone was performed illicitly in the 1950s to 1960s and was subsequently prohibited. Many complications arise from silicone injection, and liquid silicone migration is a complication that has not been widely reported. The 55-year-old woman was admitted with a palpable mass on her neck; her symptom started 2 weeks ago. Two years previously, she had received bilateral cosmetic silicone fluid injection in the multiple regions of her face. On physical examination, a 6 × 8-cm palpable mass was seen on anterolateral aspect of the right sternocleidomastoid muscle. On enhanced facial computed tomography, multiple abscesses were in the right malar, cheek, and preauricular region with abscess tract sequelae. The author prescribed cephalosporin intravenous antibiotics and performed 2 cm of incision line on the lower one-third neck with local anesthesia, and then drain tube was applied. After 5 days, mass on the neck was not palpated, and right buccal swelling was significantly diminished in size and reflected the resolution of the surrounding inflammatory reaction. Bacterial culture reported growth of some gram-negative rods, Burkholderia gladioli. All injectable dermal fillers can cause complications. Immediate reactions are transient and can include edema, erythema, nodularity, and pain. Late averse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma, autoimmune responses, or both. So in this case, the author guessed that silicone fluid causes abscess and then pseudocyst formation on the neck. The key to an accurate diagnosis is asking the patient specifically about his/her history of receiving cosmetic filler injections.

UI MeSH Term Description Entries
D007267 Injections Introduction of substances into the body using a needle and syringe. Injectables,Injectable,Injection
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009333 Neck The part of a human or animal body connecting the HEAD to the rest of the body. Necks
D002610 Cheek The part of the face that is below the eye and to the side of the nose and mouth. Bucca,Buccas,Cheeks
D003357 Cosmetic Techniques Procedures for the improvement or enhancement of the appearance of the visible parts of the body. Cosmetic Technics,Cosmetic Technic,Cosmetic Technique,Technic, Cosmetic,Technics, Cosmetic,Technique, Cosmetic,Techniques, Cosmetic
D003560 Cysts Any fluid-filled closed cavity or sac that is lined by an EPITHELIUM. Cysts can be of normal, abnormal, non-neoplastic, or neoplastic tissues. Cyst
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000038 Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Abscesses
D020034 Silicone Gels Synthetic organosiloxane gels that are formed from synthetic polymers of silicone oxide with organic sidechains (polydimethylsiloxane) by lengthening the polymer chains. Unlike silicone elastomers, they are not treated with amorphous silica. They are used as fillers in breast implants. Gels, Silicone

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