Modified Charles Procedure for Tissue Destruction after Gluteal Silicone Injection in a Transgender Woman

Author Info

Andrew B Siref Edward C Ray Philip Brazio Smita Mascharak Thomas M Hagopian

Corresponding Author

Philip Brazio
Division of Plastic and Reconstructive Surgery, University of Southern California

A B S T R A C T

A 49- year-old male-to-female transgender patient presented to the Emergency Department with inflammation and soft tissue necrosis of the right leg. She had undergone injection of liquid silicone into her buttocks and hips for cosmetic purposes five years prior, causing several episodes of infection and longstanding open wounds over the buttocks and both lower extremities. Limited debridement, antibiotics, and local wound care did not halt the slow progression of tissue loss. Radical dermofasciectomy of the right leg was performed, followed by split thickness skin grafting from the back. The grafts healed well and the patient regained full leg function. Large volume injection of industrial-grade liquid silicone is an unfortunately common practice, often used by unlicensed racketeers in feminization procedures. Devastating complications may occur well away from the zone of injection. As gender affirming procedures become more prevalent, so does the potential for complications associated with the inappropriate use of liquid silicone injection. Early recognition of these complications can allow the institution of appropriately aggressive therapy. In a scenario of widespread infectious and inflammatory damage to soft tissues of the limb, wide dermofasciectomy with split thickness skin grafting should be considered as an option for limb salvage.

Article Info

Article Type

Case Report

Publication history

Received: Mon 13, Aug 2018
Accepted: Tue 04, Sep 2018
Published: Wed 10, Oct 2018

Copyright

© 2023 Philip Brazio. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2018.03.003