Lethal silicone embolization syndrome complicating penile, scrotal and breast self-augmentation

Abstract

A 62-year-old man died following injection of liquid silicone into his external genitalia and chest wall. The body was discovered naked, apart from a pair of black women's high-heeled shoes, black ankle restraints, which were chained together, and disposable medical gloves. Medical items in the house included syringes, needles, alcohol wipes and unmarked/labelled empty brown glass medical bottles. At autopsy the external genitalia were markedly enlarged with white dressings over injection sites in the scrotum, penis and above the left nipple. Histological examination of the scrotum, penis and breast showed a florid granulomatous foreign body giant cell reaction and scarring surrounding numerous optically clear vacuoles. The lungs also showed numerous vacuoles within the interstitium in keeping with embolization of injected material. Death was due to silicone embolization. Despite the dangers of liquid silicone injections for soft tissue augmentation, and the ban on its use for medical cosmetic procedures, this practice continues.

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