Silicone Pneumonitis after a Cosmetic Augmentation Procedure

Abstract

The injection of silicone for cosmetic procedures is common practice in the United States. We describe a case of severe silicone-induced pneumonitis leading to respiratory failure. A previously healthy 30-year-old woman presented with progressive cough and shortness of breath of 10 days' duration. For cosmetic augmentation, an unlicensed nurse had given the patient two silicone injections into her buttocks 12 days and 2 days before admission. At the initial evaluation, the patient's oxygen saturation was 63 percent while she was breathing ambient air; her pulse was 119 beats per minute, blood pressure 98/66 mm Hg, respiratory rate 20 breaths per minute, and temperature 38.3°C; auscultation revealed diffuse rhonchi throughout the lungs. Her chest radiograph showed infiltrates in the lower left lobe. Laboratory studies showed a white-cell count of 13,300 per cubic millimeter and a hematocrit of 37 percent. Arterial blood gas measurements revealed respiratory alkalosis with pronounced hypoxemia.