Silicone injections

(clik aquí para la traducción española)

OK, this may surprise everybody, but I have advice for women in transition seeking silicone injections, and it's not a blanket condemnation.

This procedure is illegal and very dangerous, but there are still people out there doing it, just like heroin. Rather than just say, "Don't do heroin," it's better to get heroin users to reduce their risks. The same is true with silicone. This will always be a problem in our community as long as there are young and poor women desperate for quick and cheap feminization of their faces and bodies.

Make no mistake, injected silicone can and does kill several transgender women a year and disfigures many more. Rather than just say it's bad, it's important to get the word out with examples of why it's bad. So you can decide if the risks are worth it.

I've compiled a list of recent articles on the topic as well as selected medical data, starting with published reports of death and disfigurements in our community. I've also started a list of tips on minimizing risks.

The most common causes of death immediately following a silicone injection are from an immune response which causes the lungs to fill with fluid, or from a pulmonary embolism. Imagine literally drowning in mucus and silicone filling your lungs. Not a great way to go.

Both an immune response and an embolism can cause rapid and certain death unless immediate emergency medical attention is sought at the first sign of itchiness, dizziness or difficulty breathing. One way to reduce risk is to do tiny amounts in several sessions, rather than huge amounts, especially on the first session.

Below: a woman who got silicone injections into her breasts for two years, starting at age 23. By age 29, she had been diagnosed with tumors, which required surgical removal of the silicone and tumors. She had numerous corrective surgeries following getting the silicone scraped out, which required removing more skin and eventually her nipples.

Photo courtesy of: http://www.siliconeholocaust.org/siliconestories2.html

Selected medical papers

Transgender-specific deaths and injuries

Hage JJ, Kanhai RC, Oen AL, van Diest PJ, Karim RB. : The devastating outcome of massive subcutaneous injection of highly viscous fluids in male-to-female transsexuals. Plast Reconstr Surg 2001 Mar;107(3):734-41

Duong T, Schonfeld AJ, Yungbluth M, Slotten R. : Acute pneumopathy in a nonsurgical transsexual. Chest 1998 Apr;113(4):1127-9

Farina LA, Palacio V, Salles M, Fernandez-Villanueva D, Vidal B, Menendez P. : [Scrotal granuloma caused by oil migrating from the hip in 2 transsexual males (scrotal sclerosing lipogranuloma)] Arch Esp Urol 1997 Jan-Feb;50(1):51-3 in Spanish)

Chastre J, Brun P, Soler P, Basset F, Trouillet JL, Fagon JY, Gibert C, Hance AJ. Acute and latent pneumonitis after subcutaneous injections of silicone in transsexual men. Am Rev Respir Dis 1987 Jan;135(1):236-40

Chastre J, Brun P, Gibert C. [Acute respiratory insufficiency following illicit silicone injections: the value of broncho-alveolar lavage] Bull Acad Natl Med 1986 Apr;170(4):531-5 [Article in French]

Chastre J, Basset F, Viau F, Dournovo P, Bouchama A, Akesbi A, Gibert C. Acute pneumonitis after subcutaneous injections of silicone in transsexual men. N Engl J Med 1983 Mar 31;308(13):764-7.

Vilde F, Arkwright S, Galliot M, Galle P, Labrousse J, Lissac J. : [Fatal pneumopathy linked to subcutaneous injections of liquid silicone into soft tissue] Ann Pathol 1983 Dec;3(4):307-12

Coulaud JM, Labrousse J, Carli P, Galliot M, Vilde F, Lissac J. : Adult respiratory distress syndrome and silicone injection. Toxicol Eur Res 1983 Jul;5(4):171-4

General reviews, animal studies and adverse reaction reports

Chaplin, C.H. (1969). Loss of both breasts from injections of silicone (with additive). Plastic and Reconstructive Surgery, 44(5), 447-450.

Ellenbogen, R., & Rubin L. (1975). Injectable fluid silicone therapy: Human morbidity and mortality. Journal of the American Medical Association, 234, 309-309.

Villa A, Sparacio F. Severe pulmonary complications after silicone fluid injection. Am J Emerg Med 2000 May;18(3):336-7

Kubota J, Fujino T, Sugymoto C, Abe T : Long term complications caused by injected silicone gel and paraffin oil. Keio J Med 1984; 33 : 127-136.

Bigata X, Ribera M, Bielsa I, Ferrandiz C. Adverse granulomatous reaction after cosmetic dermal silicone injection. : Dermatol Surg 2001 Feb;27(2):198-200

Schoeller T, Gschnitzer C, Wechselberger G, Otto A, Hussl H, Piza-Katzer H. [Chronic recurrent, locally destructive siliconomas after breast augmentation by liquid silicone oil]. Chirurg 2000 Nov;71(11):1370-3

Frey HP, Lemperle G, Exner K. [Siliconoma and rheumatic symptoms--a familiar and a questionable complication of silicone implantation] Handchir Mikrochir Plast Chir 1992 Jul;24(4):171-7; discussion 178

Holm C, Muhlbauer W. Toxic shock syndrome in plastic surgery patients: case report and review of the literature. Aesthetic Plast Surg. 1998 May-Jun;22(3):180-4.

Sergott TJ, Limoli JP, Baldwin CM, Laub DR : Human adjuvant disease, possible autoimmune disease after silicone implantation : A review of the literature, case studies, and speculation for the future. Plast Reconstr Surg 1986; 78 : 104-114.

Meigel W, Winzer M, Berg A, Wolff HH. [Siliconoma] Z Hautkr 1989 Sep 15;64(9):815-6

Jansen T, Kossmann E, Plewig G. [Siliconoma. An interdisciplinary problem]. Hautarzt 1993 Oct;44(10):636-43

Lai YL, Weng CJ, Noordhoff MS. Breast reconstruction with TRAM flap after subcutaneous mastectomy for injected material (siliconoma). Br J Plast Surg 2001 Jun;54(4):331-4

Zager W. Silicone flash after laser use Archives of Otolaryngology--Head and Neck Surgery 2001;127:418-421.

Kopf, E.H., Vinnik, C.A., Bongiovi, J.J., & Dombrowski, D.J. (1976). Complications of silicone injections. Rocky Mountain Medical Journal, 75, 77-80.

Kopf EH. Injectable silicones. Rocky Mt Med J. 1966 Mar;63(3):34-6.

Solomons ET, Jones JK. The determination of polydimethylsiloxane (silicone oil) in biological materials: a case report. J Forensic Sci 1975 Jan;20(1):191-9

Parsons, R.W., & Titering, H.R. (1977). Management of the silicone injected breast. Plastic and Reconstructive Surgery, 60, 534.

Spira M, Rosen T : Injectable soft tissue substitutes. Clin Plast Surg 1993; 20 : 181-188.

Megumi Y. Immediate breast reconstruction with subpectoral implantation after transaxillary subcutaneous mastectomy for siliconoma. Aesthetic Plast Surg. 1989 Winter;13(1):27-32.

Baruch J, Wechsler J, Bodin B, Raulo Y. [Slowly evolving breast siliconoma] Ann Chir Plast. 1982;27(2):183-4. French.

Ashley FL, Braley S, Rees TD : The present status of silicone fluid in soft tissue augmentation. Plast Reconstr Surg 1967; 39 : 411-418.

Ashley FL, Braley S, McNall EG. The current status of silicone injection therapy. Surg Clin North Am. 1971 Apr;51(2):501-9.

Habal MB : The biologic basis for the clinical application of the silicones. Arch Surg 1984; 119 : 843- 848.

Habal MB, Powell ML, Schimpff RD. Immunological evaluation of the tumorigenic response to implanted polymers. J Biomed Mater Res. 1980 Jul;14(4):455-66.

Duffy MJ, Woods JE. Health risks of failed silicone gel breast implants: a 30-year clinical experience. Plast Reconstr Surg 1994 Aug;94(2):295-9

Selmanowitz VJ, Orentreich N. Medical-grade fluid silicone. A monographic review. J Dermatol Surg Oncol. 1977 Nov-Dec;3(6):597-611.

Orentreich DS. Liquid injectable silicone: techniques for soft tissue augmentation. Clin Plast Surg. 2000 Oct;27(4):595-612.

Ben-Hur N, Neuman Z. Siliconoma--another cutaneous response to dimethylpolysiloxane. Experimental study in mice. Plast Reconstr Surg. 1965 Dec;36(6):629-31.

Sclafani AP, Romo T 3rd.Injectable fillers for facial soft tissue enhancement. Facial Plast Surg. 2000;16(1):29-34.

Millard D.R., Maisels D.D. : Silicone granuloma of the skin and subcutaneous tissue. Am J Surg 1966;112 : 119.

Travis WD, Balogh K, Abraham JL : Silicone granulomas : Report of three cases and review of the literature. Human Pathol 1985; 16 : 19-27.

Lorenz R, Stark GB, Hedde JP. [The value of sonography for the discovery of complications after the implantation of silicone gel prostheses for breast augmentation or reconstruction]
Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1997 Mar;166(3):233-7. German.

Mitnick JS : Fine needle aspiration biopsy in patients with augmentation prostheses and a palpable mass. Ann Plast Surg 1993; 31 : 241-244.

Requena C : Adverse reactions to injectable aesthetic microimplants. Am J Dermatopathol 2001 Jun;23(3):197-202

Duffy MJ, Woods JE. Health risks of failed silicone gel breast implants: a 30-year clinical experience. Plast Reconstr Surg. 1994 Aug;94(2):295-9.

Other silicone sites

FDA warnings

U.S. Food and Drug Administration documents show links to autoimmune disorders, connective tissue disorders, genetic mutations, and cancer.

From http://www.fda.gov/cdrh/ost/rpt97/OST1997AR86.HTML

Autoimmune diseases have been reported in women with silicone breast implants. The presence of autoantibodies in some of the women, as well as studies in experimental animals, suggest that silicone may play a role in these adverse effects on the immune system.

Our earlier studies have shown that silicone gel/oil can promote autoantibody production against the connective tissue proteins, collagen, and can migrate from the implant site to other parts of the body.

Serum samples of 180 women have been analyzed for autoantibodies to collagen, a connective tissue protein. Patients included women with or without breast implants, with or without autoimmune symptoms, and from normal controls. Autoantibodies to collagen were detected in patients with connective tissue disease + silicone breast implants, with connective tissue disease without silicone breast implants, and with silicone breast implants without connective tissue disease. Autoantibodies to collagen were not detected in control sera from normal volunteers.

Published studies also have shown that animals with autoimmune disease produce antibodies against their own DNA. We have found anti-DNA antibodies in the serum of experimental animals injected with silicone gel/oil. Based on these results we will determine if women with breast implants also produce autoantibodies against DNA.

From http://www.fda.gov/opacom/backgrounders/collagen.html

Has liquid silicone been approved by FDA for injection?

No. FDA has not approved the marketing of liquid silicone for injection for any cosmetic purpose, including the treatment of facial defects or wrinkles, or enlarging the breasts. The adverse effects of liquid silicone injections have included movement of the silicone to other parts of the body, inflammation and discoloration of surrounding tissues, and the formation of granulomas (nodules of granulated, inflamed tissue).

Can FDA prohibit doctors from promoting the injection of liquid silicone, since its marketing has not been approved?

Yes. FDA prohibits manufacturers or doctors from marketing or promoting unapproved products such as liquid silicone. This means that a doctor cannot legally advertise or sell this material.

From http://vm.cfsan.fda.gov/~frf/forum97/97G14.htm

FDA on mutations and cancer (foreign body carcinogenesis):

After 12 months, fibrosarcoma in situ developed in 100% of rats implanted with either silicone or cellulose.

AEGIS warnings

The American Educational Gender Information Service (AEGIS) was an important early TG advocate in the field of health issues. They put out a series of articles, ads and pamphlets called Dangerous Curves Ahead, which remains an important overview of injectable silicone's dangers.

Advisories against the procedure:

http://www.gender.org/resources/curves.html

http://www.gender.org/resources/bad_news.html <-- highly recommended
http://www.gender.org/resources/malas_noticias.html (traduccion en español)

Other warnings and reports

American Society for Aesthetic Plastic Surgery advisory against the procedure:
http://surgery.org/news_releases/oct3001silicone.html

Side effects described by victim:
http://neuro-www.mgh.harvard.edu:16080/forum_2/SiliconeRelatedF/11.6.998.29AMREMOVALOFFAC.html

Granulomas:
http://ej.rsna.org/ej3/0112-99.fin/body/introduction-4.htm

Report on the silicone craze in Florida:
http://abcnews.go.com/sections/GMA/GoodMorningAmerica/GMA020128Silicone_lip_investigation.html
http://www.click10.com/mia/news/stories/news-56479220010329-130339.html
http://www.sptimes.com/News/041801/State/_It_s_food__drink_and.shtml

Silicone + laser skin resurfacing = flash fire:
http://archotol.ama-assn.org/issues/v127n4/abs/ooa00018.html

Risk overviews:
http://www.med.gazi.edu.tr/journal/1997_2_93_95.html
http://www.avitro.com/silsafe.htm

Naoum C, Dasiou-Plakida D, Pantelidaki K, Dara C, Chrisanthakis D, Perissios A. A histological and immunohistochemical study of medical-grade fluid silicone. Dermatol Surg. 1998 Aug;24(8):867-70. PMID: 9723051

BACKGROUND: Medical-grade injectable silicone for use in soft tissue augmentation is administered subcutaneously by injections of the pure material. OBJECTIVE: To examine histologically and immunohistochemically the characteristics of medical-grade silicone and to identify the advantages and disadvantages of the serial puncture technique. RESULTS: In early biopsies, perivascular lymphocytic infiltration with the characteristic reaction of delayed hypersensitivity (doses, 0.05-0.07 mL) was observed. Immunohistochemically, small local deposits of IgG and IgA were observed around the walls of small vessels. In later biopsies, the inflammation had progressed to a fibroblastic reaction. Additionally, the implantation of large doses provoked giant cell granulomas. CONCLUSIONS: Small doses (0.05-0.07 mL) of injected silicone produce an immunologic and fibroblastic reaction in the skin. The use of this substance with the serial puncture technique is not hazardous when proper technique is used.

Rapaport MJ, Vinnik C, Zarem H. Injectable silicone: cause of facial nodules, cellulitis, ulceration, and migration. Aesthetic Plast Surg. 1996 May-Jun;20(3):267-76. PMID: 8670396

Fifty-four patients with problems following "medical grade" silicone injections into the face and legs were seen from 1974 until 1995. Complications consisted of chronic cellulitis, nodules, foreign body reactions, and movement of material to near and distant parts of the body. These difficulties usually demonstrated themselves many years after injection. It is suggested that problems occur despite good technique, good material, and small amounts injected. Because the side effects are unpredictable and often uncorrectable, further studies must be performed to insure silicone's safety.

Beekman WH, Hage JJ, Jorna LB, Mulder JW. Augmentation mammaplasty: the story before the silicone bag prosthesis. Ann Plast Surg. 1999 Oct;43(4):446-51. PMID: 10517477

Czerny from Heidelberg is generally accepted to have performed the first augmentation mammaplasty in 1895. Since then, a variety of nonsilicone materials have been injected or implanted to augment or to reconstruct the hypoplastic female breast, including autologous tissues, intramammary- or submammary-injected alloplastic materials, and preformed alloplastic materials other than silicone. For various reasons outlined in this review, none was fully acceptable. The introduction of the medical-grade silicone bag prosthesis in the early 1960s improved the results of mammary augmentation dramatically and reduced the incidence of fibrous contracture and implant extrusion. Other methods of breast augmentation became obsolete.

Leibman AJ, Sybers R. Mammographic and sonographic findings after silicone injection. Ann Plast Surg. 1994 Oct;33(4):412-4. PMID: 7810958

The illicit use of silicone injection for cosmetic augmentation was performed in the 1960s. However, this method of augmentation was subsequently abandoned. Recently, a resurgence of this practice has occurred. We present reports of 2 patients who had non-medical-grade silicone injected into their breasts clandestinely. The clinical findings and imaging features are presented.

Duffy DM. Silicone: a critical review. Adv Dermatol. 1990;5:93-107; discussion 108-9. PMID: 2204381

The response of biologic systems to implanted foreign materials is subject to a lesion of variables. Each type of implant must be individually evaluated in a specific application and host. Pure DMPS polymer injected into subcutaneous tissues behaves in a specific and characteristic way. An analysis of the behavior of other types of implants in other applications will not necessarily reveal insights applicable to the behavior of liquid silicone. Most adverse case reports relate to injected fluids of unknown purity or identity used in inappropriate volumes in poorly chosen anatomical sites. It is ironic that pure DMPS in small volumes, a theoretically ideal combination, is so mistrusted. However, liquid silicone's sinful potential was easy to predict. It was cheap, available, easy to use, and, when injected in large volumes, produced instant and financially profitable results. Moreover, a welter of confusing titles, "authorized investigators" and "medical grade silicone" coupled with sensationally adverse reports detailing a criminal misuse of this modality led to draconian measures banning its use and made a meaningful analysis of true incidence and type of side effects following its use nearly impossible to assess. The advocates' position that liquid silicone is safe when used properly cannot be refuted. Only a handful of serious adverse reactions can be documented following its use; however, the concept that pure DMPS polymer can, even in expert hands, occasionally produce immunologically mediated adverse effects is equally irrefutable. This concept is supported by the following evidence: 1. Minor idiosyncratic and granulomatous reactions occurring in 1 in 10,000 are reported in association with a nidus of infection or as a consequence of allergic events. 2. At least one serious inflammatory reaction occurred in a patient afflicted with both autoimmune disease and concurrent infection. These reactions are best understood in the broader context of tissue responses to all classes of implanted foreign material, and they are most easily understood in the narrow context of autoimmune disease after injection of implantable paraffin, silicone, and possibly "silicone polymers." "Certain authors speculate that silicone acting as a primary antigen is not likely," however, silicone acting as an adjuvant associated with a subclinical infection as an antigen source may be the cause of adjuvant disease. A careful review of published anecdotal and personal experience involving the use of 350 centistoke pure dimethypolysiloxane fluid (liquid silicone) for soft-tissue augmentation in small volumes (and in large volumes for facial hemiatrophy) suggests that the bias against its proper use is unfounded.

Wilkie TF. Late development of granuloma after liquid silicone injections. Plast Reconstr Surg. 1977 Aug;60(2):179-88. PMID: 887659

In a 10-year experience with silicone injections involving 92 patients, there was subsequent development of a granuloma in 13 injection sites. Most of these occurred within 12 months, but some took a few years and one appeared 7 years later. It is believed that the injected material was medical grade liquid silicone, without additives or contaminants.

Webster RC, Gaunt JM, Hamdan US, Fuleihan NS, Smith RC. Injectable silicone for facial soft-tissue augmentation. Arch Otolaryngol Head Neck Surg. 1986 Mar;112(3):290-6. PMID: 3942634

Medical-grade injectable silicone has been safely and efficiently used for facial soft-tissue augmentation in 235 patients. Our 20-year experience with the microdroplet technique included 2,811 treatments performed for camouflaging furrows and grooves, augmentation of facial eminences, and elevation of certain depressed scars. The indications and techniques of injection are discussed. The augmenting effect is greater than that produced by the small volumes of silicone injected. Our study supports other work indicating induction of collagen deposition in the patients around the microdroplets of silicone, thus providing augmentation from volumes of collagen and silicone as well.

Hexsel DM, Hexsel CL, Iyengar V. Liquid injectable silicone: history, mechanism of action, indications, technique, and complications. Semin Cutan Med Surg. 2003 Jun;22(2):107-14. PMID: 12877229

Medical grade liquid injectable silicone can be used for soft tissue augmentation to correct and replace lost volumes of the subcutaneous tissue. It is potentially a permanent tissue augmentation agent and is the most effective filler for certain indications. This article presents the history, mechanism of action, indications and contraindications, technique, and the possible complications of silicone and their treatment.

Bigata X, Ribera M, Bielsa I, Ferrandiz C. Adverse granulomatous reaction after cosmetic dermal silicone injection. Dermatol Surg. 2001 Feb;27(2):198-200. PMID: 11207699

BACKGROUND: Various alloplastic injectable implants have been developed for soft tissue augmentation without surgery, but different local or systemic adverse reactions have limited their use for cosmetic purposes. OBJECTIVE: To examine the problems associated with silicone injection. METHODS: Case report and literature review. RESULTS: We describe an adverse granulomatous reaction after the injection of liquid silicone for lip augmentation, causing facial disfigurement. Although the initial response to steroids was poor, after 3 years of follow-up the nodules have almost disappeared spontaneously. CONCLUSION: We advise that silicone injection be performed solely by trained physicians using medical-grade silicone or consider other injectable materials.

If you decide to do it anyway

So, you have looked through all of this and still think it's a good idea. Here are my tips for getting the best results with injectable silicone:

Go to a country where it's legal and performed by experienced physicians. South America is the best bet. I wouldn't do it in Mexico, personally.

Barring that, go talk to the local drag queens-- the ones who win pageants. They can hook you up with someone who rolls through town every now and then. This is your best bet for getting high-quality medical grade silicone done by someone with experience and skill. However, most of these people who do pumping are not medically trained. One that killed someone in Florida in 2001 was a housecleaner, and I know a TG woman who does it who is a construction worker.

Don't get referrals from hookers or poor girls (esp. Latina chicks, in whose community it's especially popular but often done under the worst conditions). The silicone will probably not be medical grade, and it's likely they'll overdo you because their clientele thinks more is more. Ever seen one of those bubble-butt queens in a club or on the track? Scary. The medical conditions will probably be less than ideal if you go the street route. One that got arrested in New York was filling used syringes out of a dirty coffee mug full of silicone. Mmm.

Don't get too much done at once. This is the most common mistake cosmetically, and the most common cause of death. It's one of the reasons it got outlawed. People were doing too much at once, and it can't settle properly if there's too much introduced at one. Get a small amount, let it settle, then get more. You'll have more problems with migration if you do too much at once. Getting too much at once may seem like a money saver, but it's the best way to get some complications. You'll feel tissue tearing away from the muscle if the silicone is placed at the right depth. If it's too shallow, it can make this skin discolor, usually darkening from the torn capillaries.

Make sure the conditions are as sterile as humanly possible. You'll probably get it done in a hotel room or somebody's apartment. Make sure you watch them unwrap the syringe. Inspect the silicone and the container. Ask what grade it is, and see if they have proof. Make sure it's medical grade 360 and not that industrial grade shit. Make sure they sterilize your butt before they do it.

Do not get tempted to pump your face. The likelihood of migration seems to be higher, and it has to be done with a subtlety few can master. Beauty is a question of millimeters, and it's easy to go too far. (There are a handful of doctors in the US using medical grade silicone face work, such as Orentreich Medical Group. This off-label use is controversial, but if you are considering putting silicone in your face, I strongly recommend doing it under the care of a medcial expert who is either a plastic surgeon or a dermatologist.) Everyone's seen those scary queens who are all lips and cheekbones. For an example, see below.

Do not put pressure on the area for a few days after injection. This can cause it to ooze out the injection holes or take an undesirable shape. This is especially true for the butt. Don't take a hot bath for a few days after.

Massage the bubbles out. It hurts like a mother, but you gotta do it. You'll feel them pop. It's usually helpful to do this after a very hot bath.

It's going to hurt like hell if you sleep, sit on or bump your silicone for anywhere from a few days to a few weeks. Bumping it even years later can hurt for some people. Try to sleep on your stomach till you feel healed.

You'll have a row of track marks on your ass-- usually four to eight running vertically along the center of the cheek. You'll also have it along your hips if you get them done (which I figure you will). If done under sterile conditions by someone good, they should fade in time.

I have felt silicone boobs and butts of friends, and I will admit that sometimes it feels quite natural. At other times, it feels lumpy. It can look good, but it does settle over time and can give you a droopy butt, especially if you do too much. Only way to fix problems is usually to live with it or have 'em go in and scrape it out. Messy.

Now, about those risks... I strongly urge you not to get this done unless you have very seriously thought about the long-term health risks. Adverse reactions to the injections may include swelling, reddening of the skin, lumpiness of the area treated and development of soft tissue tumors.

I have three close TG friends who had injectable free silicone. Two were showgirls for a long time (one still is)-- one had way too much, the other had about the right amount, if you're going for that drag aesthetic. A third (the most passable) had minimal amounts.

The one with minimal amounts has some sort of autoimmune problem that has doctors baffled. She has what looks like an enormous raised welt covering her right shoulder blade, except it's firm to the touch, like a giant cyst, possibly a lipoma. Many specialists, herbalists, acupuncturists, etc. later, it's still there. Oh, and she's 30.

Is it related to silicone? Maybe, maybe not. That's the weird thing. Introducing foreign materials into the body, especially products that have not been evaluated for safety and effectiveness, could cause all sorts of problems. It's what they call an unknown risk.

Overdoing it

How much is too much? This chick is named Jocelyne Wildenstein, and she LOVES her look. Really. The question is how others will perceive you. If you wish to be accepted as female, this isn't going to do you any favors.

from this to this:

Most plastic surgery procedures used in facial feminization reduce the size of features, like nose, forehead, or chin. Silicone can only add to the face, so some people try to use it to make other parts of the face look proportionally smaller. Besides adding it to cheekbones and lips, some even use it to fill in a brow ridge, cleft chin, etc. These additions give a very characteristic moonfaced look. Go to any drag pageant, and you'll see a few women who have overdone it. Many women I know who got their lips pumped keep their mouth in this open fish-faced manner.

Some women are actually going for this garish, exaggerated look. However, if you're young and wish to pass, I strongly advise not doing silicone in your face no matter what, even if you decide to risk putting it in your breasts or butt. It's just too hard to do right, and it's more likely to shift or cause problems later.

Reports of silicone deaths and injuries

In 2003, a transgender "pumper" named Donnie Hendrix and an accomplice were sentenced to prison after a woman they were injecting with silicone designed for use in making furntiure died of silicone in her lungs.

In August 2003 Guadalupe Camarena was charged with aggravated assault and serious bodily injury after Delfino Gonzales died of asphyxiation three days after being injected. Physicians described the death as "agonizing." This death came just weeks after another Houston resident, San Chiem, died two days after receiving silicone injections.

In January 2004, 23-year-old Andre D. Jeter succumbed to complications from silicone injection one month after suffering convulsions and falling into a coma during ``pumping party'' in Georgia. Stephen Oneal Thomas, Nikkia Scott, Mark (Jazz) Edwards, Kontavius Parks, were charged in the case.

A reader writes in August 2003:

One I just want to be the first to really promote active awareness of the dangers of sillicone, and yes I'm bordering on becoming a horror story, age 21 had injectable silicone, gone thru all sorts of medical problems while younger including immune failure, and more now 26 I have tumors/and lymphatic tissue granulomas... untill now I have not had them removed because I don't know of the results or anyone whose had any success with such or whom might be the best to consult with... do you have any advise?

Because it is an illegal procedure, many doctors will not remove injected silicone unless there is a medical necessity. I will try to find information on options.

Below is a March 2004 article on abcesses (pus-filled pockets) in 25 women who were pumped in the New York area.

J Am Acad Dermatol. 2004 Mar;50(3):450-4. Related Articles, Links
 
Mycobacterium abscessus cellulitis and multifocal abscesses of the breasts in a transsexual from illicit intramammary injections of silicone.
Fox LP, Geyer AS, Husain S, Della-Latta P, Grossman ME.
We report the case of a 29-year-old transsexual who developed Mycobacterium abscessus infection after receiving intramammary liquid silicone injections in the nonphysician office setting. Our patient represents 1 of 14 confirmed and 11 suspected cases in New York City of M abscessus infection after illicit cosmetic procedures. As injectable cosmetic procedures are becoming increasingly popular, dermatologists should be aware of both the common and unusual complications. Furthermore, all physicians should be alerted to the current cluster of M abscessus infections after injections for cosmetic purposes by nonmedical practitioners in New York City.
PMID: 14988690

From a reader in May 2005:

Hi, some months ago I allowed a New Jersey transgender woman to talk me into allowing her to inject me with silicone in my hips and buttocks for a fee.  After the injections I became critically ill and was rushed to the hospital.  "I couldn't breathe!"  I was in respiratory distress, nor could I stand or walk.  After I was examined I was told that the silicone had poisoned my system and that they could not promise any positive outcome, and that I could possibly die.  Today, I am still having problems with joint pain, nerve and psychological damage.  I am also (HIV +) and all the silicone did was push me closer to death.  My immune system was compromised by the silicone and all the anti HIV meds are now not working.  I honestly wish to God that I would have never had the procedure done.  I was such a fool.  All I can say to all the girls out there who are considering getting pumped with silicone is; Please, please don't do it.  It's not worth losing your life over or the pain and health problems that go with it.  And you will be very sorry in the long run.  Thanks for posting the information on this web page because all the girls need to know the facts.  I wish I could've read it before I got injected with silicone.

San Diego, June 2005:

Sammia " Angelica" Gonzalez allegedly pumped several trans women in the San Diego area, and two immediately had trouble breathing and had to be placed on emergency life support. One of the women is not expected to live.

John Di Saia MD wrote:

Here we go again folks. Silicone gel injections are once again becoming popular. This time people are dying from them. The Reuter's piece cites examples in San Diego and Los Angeles, California. A few years ago it was in Florida. We don't learn.

We have known that silicone gel injections were a dangerous proposition for years. Why is it that people still seek them?

I remember as a resident a patient who had had silicone gel injected into her breasts. This left her with breasts filled with nodules that felt like rocks. These hurt her a great deal. We ended up reconstructing her breasts utilizing her tummy tissue (Free TRAM) following mastectomies. Her results were numb breasts, but the pain was gone.

A high price to pay for being stylish. Please research that which seems "new and different" before having it. You might find that it is neither new nor different. It might also not be desirable.

Silicone endangers transgender group

By Alex Roth
UNION-TRIBUNE STAFF WRITER

photo by PEGGY PEATTIE / Union-Tribune

Arlene Lafferty (above) uses makeup to hide the adverse effects of silicone injections in her face. She says her decision to drive to Tijuana for the injections a few years before her sex-change operation was a youthful mistake.

July 3, 2005

A few years before a sex-change operation turned her into a woman, Arlene Lafferty decided she wanted to look more feminine. So she drove to Tijuana, where a doctor injected silicone into her face.

The before-and-after photos are striking: What had been a masculine visage became soft and curvy, with high, rounded cheekbones – a feminine face, a woman's face.

Three decades later, however, Lafferty's cheeks have dropped and her forehead has hardened into a series of discolored, needle-marked bumps. She's developed rheumatoid arthritis, a condition she attributes to the silicone rather than the aging process. (She won't reveal her birth date because "a lady never tells her true age.")

The Mission Valley-based electrologist gestured at her sagging face and warned about injecting a product whose industrial applications include window sealant and bathroom caulking.

"This is what you have to look forward to in the years to come," she said.

Injecting silicone into the body for cosmetic purposes is a procedure that few if any doctors would recommend. Nevertheless, it remains popular in the nation's transgender communities, where illegal "pumping parties" provide the chance for groups of people to get injections at somebody's house, apartment or motel room.

Two weeks ago, two people who attended a pumping party in North Park were hospitalized after receiving injections in their hips and buttocks. Both remain comatose, one isn't expect to live and San Diego homicide detectives have issued an arrest warrant for the woman suspected of giving the injections.

In recent years, several people in other states, including Georgia and Florida, have been prosecuted for giving silicone injections to transgenders who died as a result.

Yet the practice continues, in San Diego and elsewhere, for a variety of reasons, according to Lafferty and other members of San Diego's transgender community, whose population is estimated at between the hundreds to perhaps 5,000 or more.

Some get the injections as a low-cost alternative to a sex-change operation or pricey hormone treatments. Some don't realize the health risks. Many are desperate to appear as feminine as possible so they can get jobs and avoid being mocked on the street.

In short, they don't want to look like cross-dressing men. They want to look like women.

"It's about being able to get up in the morning and walk down the street without being ridiculed or physically abused," said Tracie Jada O'Brien of the Transgender Community Coalition of San Diego.

The misuse of silicone for cosmetic touch-ups is not unique to the transgender community. Dr. Leroy Young, who heads the emerging trends task force of the American Society of Plastic Surgeons, said a woman once came to him after receiving silicone injections in her lips at a pumping party.

The results had been disastrous. Young informed the woman, whose wedding was only weeks away, that he could do nothing to fix the damage.

"She ended up with lips that look like Donald Duck," said Young, a St. Louis plastic surgeon.

Except in certain retinal procedures, the federal Food and Drug Administration hasn't approved any medical use for silicone injections, Young said.

Putting silicone into the body, experts say, can have horrific consequences. The substance can migrate to the lungs or into the blood stream, causing obstruction of the blood vessels. It can produce scar tissue that forms into hard lumps in the body – "just like a bag of marbles," Young said.

"There are an unbelievable number of dangers," said Dr. Steven Cohen, a La Jolla plastic surgeon.

San Diego police aren't releasing the names of the two San Diegans who now lie comatose on life-support systems after attending a June 19 pumping party on Florida Street.

San Diego police homicide detective Kevin Rooney said the woman suspected of giving the injections – Sammia Gonzalez, 39, of Lynwood, near Los Angeles – is wanted on suspicion of practicing medicine without a license. More charges could follow should either of the victims die, he said.

Rooney said detectives have few tips or leads on where Gonzalez might be.

"There's a possibility she's in Mexico," he said.

Members of San Diego's transgender community say Gonzalez has been here before. News of the parties usually spreads by word of mouth, with tips passed along at a few select clubs in North Park, Hillcrest and downtown.

Some transgender activists applaud people who perform what they call a valuable service, helping transgenders look "passable." They note that many are in a Catch-22 situation – too poor to afford the plastic surgery or sex-change operations that would make them more employable by helping them look biologically female.

The idea that a person should simply abstain from these types of underground procedures "doesn't acknowledge the complexities of some transgender people's lives," said Carrie Davis of the New York City Lesbian, Gay, Bisexual and Transgender Community Center.

Davis pointed out that pumping parties have been a fact of life for decades in New York, Los Angeles and other cities.

"These parties have been going on for as long as the transgender communities have been organized as such," she said.

She believes the "vast majority" of transgenders are living happier lives as a result of their silicone injections, although she added, "I'm saddened that our community is driven to such extreme measures."

Lafferty, the electrologist, understands why so many transgenders turn to silicone. Still, the risks outweigh the benefits, she said, citing her own long list of current ailments, which also include cataracts and bruises all over her body.

Her decision to get the silicone treatments was a youthful mistake, she says now, made at a time when she knew she could no longer live her life looking like a man.

"In my mind I never thought of myself as male," she said. "I understand myself. I know what I want to be – not what I want to be, what I am. And that's female."

Nowadays, most of Lafferty's clients are transgenders who come to her to get permanent makeup or to get hair removed from their faces and other parts of their bodies. For an additional fee, she gives them gentle tips on how to dress, how to walk, how to modulate their voices.

"This is a charm school here," she said one recent afternoon, sitting in her Mission Valley office.

The goal is to help her clients "to be able to pass as best as possible," she said. "Not perfectly, but as best as possible."

See also:

Risks and Complications of Liquid Silicone

http://www.yestheyrefake.net/liquid_silicone_risks.htm

Silicone Injection Web Resource

http://www.gotpummped.org

Cleopatra's needle: The history and legacy of silicone injections

http://leda.law.harvard.edu/leda/data/197/mwebb.html

Conclusion

I strongly urge you not to get silicone injections. The risks of death, injury, poor cosmetic results, and long-term problems are just too high.

I have a friend who transitioned who was a stripper for many years, and her booty is way better than anyone I've met who had silicone. She got hers through diet and specific butt exercises. She is utterly unclockable, and has the most knockout body of any woman I know personally, from our community or not. Personally, I'd give that a shot before getting pumped. But it's your call. Hope this helped.