The injection of illicit foreign substances has increased. People are injecting non medical grade substances into faces, lips, breasts, and buttocks. What can happen? Lots of bad things. This was in the February 2024 Aesthetic Surgery Journal “Cosmetic Injection of Illicit Foreign Materials: Imaging Features and Patterns of Migration in 413 Cases.” They looked at clinical and imaging records, noting the type of injected substance, imaging method for diagnosis, and patterns of migration.
What did they find?
- most of the patients were female, mean age 44
- most common area infiltrated was buttocks, followed by breast
- MRI was the most common imaging study
- Depth of injection was most frequently in the muscle
- Migration was detected in 56% of patients who had an imaging study
- Most substances were unknown. Biopolymers were the most commonly identified substance. (Biopolymers are often calcium hydroxyappetite, collagen, and hyaluronic acid)
- Depending on type of substance, migration rates varied from 13-29%, though rate differences were not statistically significant
- Migration was more common when the depth was in the muscle, rather than in subcutaneous tissue. This rate was statistically significant.
- Pain was the most common symptom which led to patients seeking help. Other common symptoms were redness, ulceration, deformity, asymmetry, and rejection of the material.
In the article it talked about what was injected. Oh my. Biopolymer was first, but followed closely by mineral oil, silicon (this is liquid free silicon, not the cohesive gel silicone seen in breast implants), vegetable oil, and unspecific oil. The results to injecting these were local and systemic. Local things were swelling, pain, skin ulceration, and exposure of the injected material. Systemic reactions were pain, fatigue, joint aches, muscle aches and weakness. There is also issues of your body trying to fight this foreign invader, leading to autoimmune issue and body inflammation. This can lead to your body chronically being on high alert due to the inflammasome reaction.
When the substance migrates? Terrible things can happen, particularly in the buttock and particularly with intramuscular injections. See my blogs on that HERE. Injections can be dangerous with medical grade dermal filler done in a board certified doctor’s office by trained injectors. It can be dangerous in an OR with board certified surgeons using your own body fat for fat transfer. Using mineral oil in some backroom in a non medical clinic? It boggles my mind.
My thoughts?
This article was shocking and sad to me. I blog to try to help educate people so they won’t fall prey to misinformation or dangerous practices. I have seen patients who were injected with what they were told is “botox” or “filler” and it clearly was not. It can cause terrible issues. These substances can migrate, get into your blood stream, cause whole body issues with autoimmune and inflammation, and cause local problems. I have seen it form nodules which are spit out of the skin years later. And most of the time, it is impossible to remove it.
Anytime you are doing anything cosmetic, the most important thing is safety. Please please be safe.