Volume 5, 2021

Medical Imaging


Yulia A. Stepanova, Nora E. Arutyunyan, Naida O. Sultanova, Aleksey A. Kopyltsov, Dmitry V. Kalinin

Pages: 119–124

DOI: 10.21175/RadProc.2021.23

Introduction.Over the past 30 years, minimally invasive methods of aesthetic medicine have become increasingly well-known in the world. Dermal fillers are among the most popular aesthetic procedures because they carry immediate results, very few risks and little recovery time. Despite the regulations governing the provision of aesthetic non-surgical medical services, the number of patients affected by the augmentation of vaseline oil into soft tissues to correct the shape of organs and soft tissues has increased. Nowadays, soft-tissue augmentation with large amounts of any foreign material and these types of procedures has been abandoned by health professionals and plastic surgeons all over the world. The administration of small doses (from 1 ml to 5 ml) of injectable preparations, mainly absorbed within 2-12 months, is permitted and widely used to correct minor contour of the face, wrinkles and soft tissues. Objective: development of an algorithm for radiological examination of patients at the stages of surgical correction of the consequences of the augmentation with vaseline oil into soft tissues for aesthetic purposes. Materials and methods.In a retrospective study, the results of the examination and surgical treatment of 17 women were evaluated. The patients were treated at various times with the consequences of the augmentation with vaseline oil in mammary glands, buttocks and shins. There were 11 (64.7%) patients with vaseline oil introduced into one region, into two regions- 5 (29.4%), and one woman 1 (5.9%) into three regions. The migration of vaseline oil to adjacent anatomical areas was observed in 13 out of 17 (76.5%) patients. All patients underwent ultrasound, MSCT, and/or MRI at the stages of surgical treatment. Results. Multiple-stages (from 1 to 8) surgical treatment was performed and in addition to excision of tissues affected by fibrosis and oleogranulomas, also reconstructive surgeries to restore the volume and contours of the organs were performed. Overall, 51 surgical interventions were performed. MSCT and MRI studies can identify oleogranulomas and determine the volume of soft tissue damage. If it is possible to choose the method of radiological investigation, preference should be given to MRI. The MR Imaging is carried out without radiation exposure and the introduction of a contrast agent and allows you to determine the full volume of soft tissue damage, as well as the presence of fibrous tissue, in the mode without fat suppression. Ultrasound is the easiest to perform, however, an effective method for diagnosing complications after soft tissues augmentation. And it is effective when searching for individual fat fragments during surgery and evaluating the intervention area around the perimeter. In the postoperative period, the ultrasound revealed limited fluid accumulations ranging in size from 12 to 36x47 mm. In 11 cases, the clusters regressed independently during ultrasound monitoring, and in 6 cases, it was considered appropriate to evacuate the contents under ultrasound control. Good and satisfactory results were obtained in 6 patients (MRI data and visual effect), and interventions, mainly of a reconstructive nature, are expected in 11 patients. Conclusion. The difficulties and multi-stage surgical treatment in patients after soft tissue augmentation with vaseline oil are associated with a large volume of tissue damage with a violation of their trophic function, the migration of vaseline oil to adjacent anatomical areas, the inability to eliminate the lesion and simultaneous reconstruction. MRI makes it possible to determine the extent of the lesion at all stages of surgical treatment, ultrasound is an important pre / intraoperative navigation during surgical treatment, and also allows postoperative management of patients.
  1. A.W. Klein, M.L. Elson, “The History of Substances for Soft Tissue Augmentation”, Dermatologic Surgery, vol. 26, no. 12, pp. 1096-1105, 2000.
    DOI: https://doi.org/10.1046/j.1524-4725.2000.00512.x
  2. R. Gersuny, “Ueber eine subcutane prothese”, Zeitschr Heilkunde Wien u Leipzig, vol. 21, sei. 199–201, 1900. (R. Gersuny, “Concerning a subcutaneous prosthesis”, Heilkunde Vienna and Leipzig Journal, vol. 21, pp. 199–201, 1900)
  3. M. L. Hedingsfeld, “Histopathology of paraffin prosthesis”, J. Cutan. Dis., vol. 24, pp. 513-521, 1906.
  4. W. Peters, V. Fornasier, “Complications from injectable materials used for breast augmentation”, Can. J. Plast. Surg., vol. 17, no. 3, pp. 89-96, 2009.
    DOI: https://doi.org/10.1177/229255030901700305
  5. J. Steffens et al., “Paraffinoma of the external genitalia after autoinjection of Vaseline”, Eur. Urol., vol. 38, no. 6, pp. 778-781, 2000.
    DOI: https://doi.org/10.1159/000020379
  6. Y. Tanaka, I. Morishima, K. Kikuchi, “Invasive micropapillary carcinomas arising 42 years after augmentation mammoplasty: A case report and literature review”, World J. Surg. Oncol., vol. 14, no. 6, article no. 33, 2008.
    DOI: https://doi.org/10.1186/1477-7819-6-33
  7. H. Bryant, P. Brasher, “Breast implant and breast cancer – reanalysis of a linkage study”, N. Engl. J. Med., vol. 332, pp. 1535–1539, 1995.
    DOI: https://doi.org/10.1056/NEJM199506083322302
  8. L.A. Brinton, S.L. Brown, “Breast implants and cancer”, J. Natl. Can. Inst., vol. 89, no. 18, pp. 1341–1349, 1997.
    DOI: https://doi.org/10.1093/jnci/89.18.1341
  9. K.A. Skinner et al., “Breast cancer after augmentation mammoplasty”, Ann. Surg, Oncol., vol. 8, pp. 138–144, 2001.
    DOI: https://doi.org/10.1007/s10434-001-0138-x
  10. S.A. Mclntosh, K. Horgan, “Breast cancer following augmentation mammoplasty – a review of its impact on prognosis and management”, J. Plast. Reconstr. Aesthet. Surg., vol. 60, no. 10, pp. 1127–1135, 2007.
    DOI: https://doi.org/10.1016/j.bjps.2007.03.017
  11. D.M. Deapen, E.M. Hirsch, G.S. Brody, “Cancer risk among Los Angeles women with cosmetic breast implants”, Plast. Reconstr. Surg., vol. 119, no. 7, pp. 1987–1992, 2007.
    DOI: https://doi.org/10.1097/01.prs.0000260582.23971.02
  12. H.F. Smetana, W. Bernhard, “Sclerosing lipogranuloma”, Arch. Path., vol. 50, pp. 296–325, 1950.
  13. V.D. Newcomer, J.H. Graham, R.R. Schafert, L. Kaplan, “Sclerosing lipogranuloma resulting from exogenous lipids”, AMA Arch. Derm., vol. 73, no. 4, pp. 361–372, 1956.
    DOI: https://doi.org/10.1001/archderm.1956.01550040055008
  14. G. Foxton, C. Vinciullo, C.P. Tait, R. Sinniah, “Sclerosing lipogranuloma of the penis”, Australasian J. Dermatol., vol. 52, no. 3, pp. e12–e14, 2011.
    DOI: https://doi.org/10.1111/j.1440-0960.2010.00665.x
  15. Е.П. Фисенко, “Инструментальная диагностика осложнений контурной пластики тела гелевыми имплантатами”, докторская диссертация, Российской Академии медицинских наук, Российский научный центр хирургии им. академика Б.В. Петровского, Москва, Россия, 2009. (E.P. Fisenko, “Instrumental diagnostics of complications of body contouring with gel implants”, Ph.D. dissertation, Russian Academy of Medical Sciences, Russian Scientific Center of Surgery named after A.I. Academician B.V. Petrovsky, Moscow, Russia, 2009.)
  16. R.E. Barlow, W.E. Torres, P.J. Sones Jr., A. Someren, “Sonographic demonstration of migrating silicone”, Am. J. Roentgenol., vol. 135, no. 1, pp. 170–171, 1980.
    DOI: https://doi.org/10.2214/ajr.135.1.170
  17. N.B. Khedher et al., “Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: patient reports and literature review”. Eur. J. Radiol., vol. 78, no. 1, pp. 104–211, 2011.
    DOI: https://doi.org/10.1016/j.ejrad.2009.09.021
  18. P. Nyirády et al., “Treatment and outcome of vaseline-induced sclerosing lipogranuloma of the penis”, Urology, vol. 71, no. 6, pp. 1132–1137, 2008.
    DOI: https://doi.org/10.1016/j.urology.2007.12.081
  19. Q. Qiao et al., “Management for postoperative complications of breast augmentation by injected polyacrylamide hydrogel”, Aesth. Plast. Surg., vol. 29, no. 3, pp. 156–161, May-Jun 2005.
    DOI: https://doi.org/10.1007/s00266-004-0099-0
  20. N.B. Khedher et al., “Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: Patient reports and literature review”, Eur. J. Radiol., vol. 78, no. 1, pp. 104–111, 2011.
    DOI: https://doi.org/10.1016/j.ejrad.2009.09.021
  21. Ю.А. Степанова, В.И. Шаробаро, И.П. Колганова, “Лучевая диагностика и лечение осложнений инъекционной контурной пластики молочных желез”, Хирургия. Журн. им. Н. И. Пирогова, № 4, с. 59-63, 2016. (Yu.A. Stepanova, V.I. Sharobaro, I.P. Kolganova, “Radiation diagnosis of complications of injection breast contouring”, Surgery Journal them. N.I. Pirogov, vol. 4, pp. 59-63, 2016.)
  22. T. Wong et al., “Magnetic resonance imaging of breast augmentation: a pictorial review”, Insights into Imaging, vol. 7, no. 3, pp. 399–410, 2016.
    DOI: https://doi.org/10.1007/s13244-016-0482-9
  23. И.Г. Мариничева, “Контурная пластика нижних конечностей”, докторская диссертация, Российский национальный исследовательский медицинский университет имени Н. И. Пирогова, Москва, Россия, 2019. (I.G. Marinicheva, “Contouring of the lower extremities”, Ph.D. dissertation, Pirogov Russian National Research Medical University, Moscow, Russia, 2019.)
Yulia A. Stepanova, Nora E. Arutyunyan, Naida O. Sultanova, Aleksey A. Kopyltsov, Dmitry V. Kalinin, "Radiology diagnostics of the consequences of vaseline oil introduction into soft tissues at the stages of surgical treatment",RAD Conf. Proc, vol. 5, 2021, pp. 119–124, http://doi.org/10.21175/RadProc.2021.23