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Buttock Filler Injection Causes Potentially Life-Threatening Infection Over A Year Later

Discussion in 'Microbiology' started by Mahmoud Abudeif, Jun 25, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    Since Sir Mix-a-Lot’s Baby Got Back first graced the music industry, the appreciation for the human buttocks has only grown. And really, why wouldn’t it? These meat cushions allow us to sit, walk, bend and snap, so that so many of us appreciate their appearance is just an added bonus. It was perhaps then inevitable that cosmetic procedures to enhance the buttocks would start to emerge, and while a person’s decision to change their appearance is nobody’s business but their own, it’s important to be wary of the potential risks of such medical interventions.

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    An early release from the European Congress of Clinical Microbiology & Infectious Diseases Conference (ECCMID 2021) outlines one such risk in a recent paper regarding buttock injections. The case study, which will be presented at the conference between July 9 – 12, outlines the experience of a 29-year-old who presented to the St James Hospital in Dublin 14 months after having undergone a buttock augmentation procedure.

    Fillers, widely used in lip-plumping procedures, have also been employed in booty-boosting treatments but their exact chemical makeup can vary from brand to brand. The injectable fillers are often cheaper alternatives to surgical procedures involving implants.

    The patient presented to the hospital with nausea and an abscess at the site where the fillers had been injected 14 months previously. The patient had also developed an infection in the fatty layer beneath the skin known as cellulitis, which can be life-threatening if left untreated. The abscess had to be drained and the patient was admitted to receive antibiotics and monitoring. Cultures revealed that Staphylococcus lugdunensis and Pseudomonas oryzihabitans were to blame for the severe infection, with the latter being a rare species for human skin and soft tissue infections.

    Imaging also revealed that the inflammation extended to the innermost layer of skin on both buttocks which was being eaten away by gas-forming organisms, forming air pockets in the tissue. To combat the deep infection, the patient had to have half a liter of dead tissue and filler material removed, after which the infection, which was circulating in her blood, soon subsided. She was eventually discharged 18 days after admission, and following a six-week course of antibiotics at home, recovered well. Exactly why the infection took over a year to kick in isn’t known for certain, but lead author Dr Siobhan Quirke from Dublin's St James Hospital explained it likely as something to do with bacteria affixing to the injected material’s surface.

    "The reason for the substantial delay between surgery and infection is not clear but may be due to the unusual organisms that can live on the surface of the dermal filler (known as a biofilm),” said Quirke in a statement. “Pseudomonas oryzihabitans is an unusual cause of human infection, but in recent years it has become increasingly linked with hospital-acquired and opportunistic infections."

    “Thankfully, treatment is not difficult due to the low level of resistance to common antibiotics. Nevertheless, this case serves as a reminder that it's important to choose a reputable cosmetic surgeon."

    While the authors of the early release express that dermal filler complications are currently quite rare, the frequency of the procedure means more cases of unexpected and unpleasant side effects are emerging as it grows in popularity.

    “Complications are increasing as fillers become one of the fastest growing cosmetic procedures,” said lead author Dr Quirke. "It's something both cosmetic patients and health professionals need to be aware of."

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