article = {SCR-2018-3-103}
title = {Modified Charles Procedure for Tissue Destruction after Gluteal Silicone Injection in a Transgender Woman}
journal = {Surgical Case Reports}
year = {2018}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2018.03.003}
url = {https://www.sciencerepository.org/charles-procedure-for-tissue-destruction-after-silicone-injection_SCR-3-103 
author = {Andrew B  Siref,Edward C  Ray,Philip  Brazio,Smita  Mascharak,Thomas M  Hagopian,}
keywords = {Liquid injectable silicone, Complications, Transgender, Gender-affirming surgery, Charles procedure}
abstract ={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.}