33977 Successful management of disseminated and disfiguring silicone granulomatosis and associated autoimmune syndrome induced by adjuvants (ASIA) as a complication of illicit filler use

Abstract

Silicone granulomatosis, both in locally destructive and disseminated forms, is an uncommon but devastating complication of illicit filler use seen most frequently in cosmetic body augmentation cases. In its most severe form, a widespread systemic inflammatory response may be triggered by the immune system’s reactivity to the illicit substance(s), often with pronounced clinical signs and symptoms. This inflammatory autoimmune syndrome induced by adjuvants has been colloquially termed ASIA in recent literature. Management of silicone granulomatosis and associated ASIA is challenging and often unsuccessful due to the pervasive intercalation of the illicit substance into local tissues and resulting persistent overstimulation of the host immune system. In this report, we present a case of severely disfiguring, disseminated silicone granulomatosis and associated ASIA as a complication of illicit filler use which was successfully managed with systemic immunomodulatory therapy.