Bilateral Gluteal Reconstruction with Double Flap Secondary to Biopolymers Injection

Abstract

The injection of adjuvant substances for aesthetic purposes is a public health problem, for 40 years this problem has been described throughout our continent, the vast majority of women patients are affected by the infiltration of silicon, mineral oils, automotive oil, methyl methacrylate, cement and various oily substances. This is a 54-year-old female patient who for about 30 years for cosmetic purposes was injected with mineral oil (quantity unknown) in both glutei with the aim of buttock augmentation. Physical examination was observed an important deformity in each buttock, hyperkeratosis with discoloration in both buttocks, loss of bilateral projection, right buttock with a secondary tumor of 22 cm × 11 cm and left 22 cm × 10 cm, stony appearance, local hyperthermia, painful on manipulation, with diffuse nodular lesions measuring 2 cm × 2 cm, without evidence of loss of continuity that would condition secretion leakage. Surgical planning is based on the very important size of the initial defect that we would have to reconstruct, so that the rotation of two wide-based flaps could guarantee better survival and occlusion of the defect, since the realization of a graft would cause a significant deformity, and the realization of a microsurgical flap in a fibrous tissue would inevitably result in its necrosis. The pathophysiology of the adjuvant disease is extremely complex, therefore it must be addressed by a multidisciplinary group with extensive experience.