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----- Original Message -----

From: " Kathi " <pureheart@...>

Sent: Friday, July 26, 2002 1:11 PM

Subject: Silicone Injections

> From:

> " Rogene " <saxony01@...>

> To:

> " Kathi " <pureheart@...>

>

>

>

>

> Newsweek

>

> http://www.msnbc.com/news/576924.asp

>

>

> THE SILICONE - which was injected into her lips and the tiny

> lines

> that were beginning to radiate around her mouth - created a hard ball on

> her

> upper lip. Within a few months, the entire lip area had ballooned to

> five

> times its normal size, so that it protruded past the end of her nose.

> " I looked like a duck from the side - people thought I had been

> severely punched, " she said.

> The quest for beauty has turned ugly for many in South Florida.

> Thousands of women and men are buying into promises of fuller lips,

> smoother

> skin and made-to-order measurements by untrained, unlicensed

> practitioners

> wielding syringes of liquid silicone, state health officials report.

> And the practice - which has been linked to severe disfigurement

> and

> even death - appears to be spreading to other areas of the country, from

>

> South Carolina to Southern California.

> For fees ranging from $100 to $500, cosmetologists, travelling

> South

> American pseudo-doctors and even house cleaners illegally inject liquid

> silicone - an oily fluid similar to the gel used inside silicone breast

> implants - into customers' wrinkles, lips, breasts, buttocks, legs and

> hips.

> The immediate effects can be pleasing - smoother thighs, tauter

> cheeks, sexier pouts - but the long-term results can be far from

> beautiful.

>

> " Imagine the biblical description of leprosy, " said Dr.

> Rosenberg, a plastic surgeon in Delray Beach, Fla., who has seen about

> 20

> silicone-injected patients in the last two years. " Their faces look like

>

> they are melting. They have boils and abscesses. "

> In at least one case, the consequences of the practice have gone

> beyond disfigurement. In March, Vera Lawrence, a 53-year-old Miami

> secretary

> and mother of two, died after she received injections of silicone into

> her

> buttocks and hips, allegedly from a house cleaner. The medical examiner

> recorded the cause of death as silicone embolism, caused when the thick

> fluid traveled to one of her lungs. This was the first such case

> recorded in

> Florida but doctors say silicone injections have likely resulted in

> other

> deaths by blocking blood vessels or leading to other damage.

> Dr. no Busso, a dermatologist in Coconut Grove, Fla., and

> clinical instructor of dermatology at the University of Miami, also

> blames

> the injections for severe bruising, recurring infections, nerve damage,

> chronic inflammation and painful tumor-like lumps. " It is crazy to do

> this,

> it's an extremely unsafe procedure, " he said.

>

> 'OPERATION HOT LIPS'

> A year and a half ago, the Florida Health Department's Office of

> Unlicensed Activity created a task force dubbed " Operation Hot Lips " to

> take

> on the underground cosmetic injection industry. The investigation has

> yielded 14 arrests, according to chief investigator Enrique .

> " We've just begun to scratch the surface, " he said. " It's an

> epidemic

> in Florida. "

> Most recently, Ruiz, who police suspect of injecting

> silicone

> into customers from her home near Miami for years, was arrested last

> month

> for practicing medicine without a license after a WTVJ/NBC 6 undercover

> investigative report tipped off the authorities. The case is currently

> awaiting trial. Calls to her lawyer were not returned.

> A woman who asked that she not be identified said she was left

>

> with lumps under her eyes and distorted lips after she received a series

> of

> injections from Ruiz.

> " She said it was the latest thing from Europe, that not a lot of

> people knew about it and it was being tested in the United States, " the

> woman recalled of Ruiz's sales pitch.

> The woman, a former model, says she feels so self-conscious about

> her

> " disfigurement " that she seldom leaves her house. She receives regular

> cortisone injections to reduce the swelling but doctors refuse to remove

> the

> silicone for fear of causing further damage.

> " I just want my face back, " she said.

> says the practice is so widespread in South Florida

> because it

> 's the gateway to South America, where silicone injections are widely

> used.

> The practice first gained a foothold in Florida among the foreign-born

> population, but it quickly crossed social, economic and racial lines.

> " I've seen it in the poorest neighborhoods and in affluent Palm

> Beach, " said.

> The practice has gained a following among AIDS patients who use

> it to

> plump up faces that have grown gaunt from anti-retroviral drugs - a side

>

> effect of the drug regimen is redistribution of body fat that can result

> in

> sunken cheeks. Transsexuals are also major consumers, using large

> volumes of

> it to create feminine curves.

>

> FROM FLORIDA TO CALIFORNIA

> The practice is not restricted to Florida. The house cleaner

> arrested

> in the death of Lawrence is suspected of running a silicone injection

> service for transsexuals in Greenville, S.C.

> Dr. Wolf, a Miami plastic surgeon, says he has treated

> patients who say they were injected in California, New York and New

> Jersey.

> " Florida is where this has been exposed because it's so rampant, "

> he

> said. " This is just the tip of the iceberg - within a year we're gonna

> find

> it all over the country. "

>

> THE LURE OF A QUICK FIX

> says clients are seduced by cut-rate prices and the

> promise of

> permanency. The effects of approved cosmetic injectables like collagen

> are

> short-lived because they are natural substances that the body absorbs

> after

> a few months.

> Koebel, who was injected by a Brazilian cosmetologist at the

> woman's

> apartment, said for $300 it sounded like a good deal: " That's less than

> collagen and you have to do that every three months, " she recalled

> thinking.

> But Dr. Malcolm , president of the American Society for

> Aesthetic

> Plastic Surgery and clinical assistant professor of plastic surgery at

> the

> University of California, Irvine, warns women: " You just might get what

> you

> wish for. It'll be permanent but then when there are problems you won't

> be

> able to get rid of it. "

> " People want a cheap, quick fix and don't even think about the

> consequences, " Wolf said.

> The trouble, Busso says, is that no one can predict who will

> have

> a bad reaction. He estimates the complication rate at somewhere around

> 10

> percent - " outrageous " for a cosmetic procedure.

> Unpredictable effects may take years to appear, or can arise

> almost

> immediately. The area of the body where the silicone is injected can

> swell

> to grotesque proportions. " I've seen lips that look like hot dogs

> sitting on

> a face, " Busso said.

> In other cases, the silicone can migrate, causing reactions in

> other

> parts of the body. Just before talking with MSNBC, for example, Busso

> consulted with a patient whose silicone had migrated from her cheeks

> down to

> her jaw, where it formed an unsightly lump.

> But the result most dreaded by plastic surgeons is the chronic

> inflammatory reaction, in which the body's immune system recognizes the

> silicone as a foreign body and mounts an all-out war against it. Large

> pockets of scar tissue can form around the silicone, creating tumor-like

>

> bulges that can continue to grow larger and larger, Busso said.

> The reaction is similar to that experienced by some women whose

> silicone gel-filled breast implants leaked or ruptured - migration of

> the

> gel with lumps of scar tissue forming around it, according to the Food

> and

> Drug Administration.

> With liquid silicone, the body's craze to get rid of the

> substance

> can trigger sudden swelling, pain, redness and fever, Busso said. " Not

> long

> ago, I had a patient who had to be admitted to a hospital eight years

> after

> being injected. Her face suddenly blew up like a balloon, turned red

> like a

> tomato and she had a fever of 103. She had to get [intravenous]

> antibiotics

> and be put on steroids, " he recalled.

>

> SILICONE SOIREES

> The underground silicone network operates on word of mouth,

>

> said. Both Koebel and the unnamed woman were referred for silicone

> injections by aestheticians at beauty salons.

> Clients go to back-room clinics, private homes and hotel rooms

> for

> the procedure. Some practitioners even host " silicone parties. "

> " Some are real high class, offering Cristal [champagne], "

> said.

> The champagne may be expensive, but the hygiene is Third World.

> said the seizure of one practitioner's bag revealed dog hair,

> candy

> remnants and used needles. He suspects some of the practitioners are

> even

> reusing needles - adding AIDS and hepatitis to the list of possible

> complications of silicone injections.

> The silicone's purity is doubtful. Often called " biopolymer " in

> the

> underground industry, patients often don't even know what substance they

> are

> having injected, noted.

> He says some of it is medical silicone brought in from outside of

> the

> country, illegally; but often it's industrial-grade silicone - the type

> used

> in paints and lacquers or to coat automobile parts. It may not even be

> silicone at all - Wolf says he has seen a patient with injected paraffin

>

> that left her face " hard as a rock. "

> Doctors say contaminants in non-medical silicone can cause

> potentially deadly reactions and horrific recurring infections.

> Rosenberg

> notes the industrial silicone may also contain carcinogenic materials.

> " People are playing Russian Roulette, " said.

>

> HISTORY OF CONTROVERSY

> Cosmetic silicone injections have a controversial past. After

> World

> War II, the shots became popular among Japanese women who would use

> liquid

> silicone to augment their breasts. In the 1960s, the practice became

> popular

> among strippers in the United States.

> The results were disastrous: hardened, lumpy painful breasts,

> with

> some women requiring mastectomies.

> Liquid silicone was never actually approved for any medical use

> during that time, but the FDA overlooked the practice until the early

> 1990s

> when it issued a ban on injecting the substance.

> Silicone gel breast implants also were banned for cosmetic use in

>

> 1992, when their makers could not prove their safety to the FDA's

> satisfaction. However, silicone implants remain an option in some

> medical

> cases - for breast reconstruction after a mastectomy, for example - and

> for

> women enrolled in clinical trials.

>

> But in 1994 a liquid silicone product was approved by the FDA

> for

> treating detached retinas. That opened an avenue for doctors to begin

> using

> liquid silicone for cosmetic injections again: Once a drug or device is

> approved by the FDA, doctors can use it as they see fit. Currently,

> there

> are two such products on the market for eye surgery.

> Dr. Orentreich, a dermatologist at the Orentreich Medical

> Group

> in New York City - and son of Dr. Norman Orentreich, who helped pioneer

> cosmetic injections of silicone - currently uses the approved

> ophthalmologic

> silicone as a wrinkle, scar and lip filler.

> However, the American Society for Aesthetic Plastic Surgery

> opposes

> cosmetic silicone injections because they are not FDA-approved,

> according to

> , the society's president.

> Wayne , president of , the developer of

> Silikon

> 1000, one of the silicone products approved for eye surgery, said his

> company does not want physicians using their product for off-label

> purposes.

> But the company will begin FDA-approved clinical trials at the

> end of

> this month on a new formulation designed specifically for cosmetic

> injections into facial wrinkles.

> expressed concern that the illegal activities in Florida

> may

> spark unfounded fears about legitimate medical uses of silicone.

> " Silicone

> is a very misunderstood substance - you can't just fill a syringe and

> inject

> it. The results can be quite disastrous if it's not done properly, but

> labeling silicone as poison is ridiculous. "

> He points out that silicone has been used successfully for years

> in

> many medical devices, from the coating on needles that allows them to

> slide

> through the skin, to artificial joints, catheters, shunts and heart

> valves

> made of solid silicone rubber.

>

> PICKING UP THE PIECES

> After the charlatans skip town, Florida's plastic surgeons and

> dermatologists are often left to pick up the pieces. " Someone who is

> doing

> this in the back of a beauty parlor or in a hotel room is not likely to

> be

> there for you when you have a problem, " said Wolf, adding that he sees

> several victims of the fad every week.

> Removing the silicone is nearly impossible and often involves

> carving

> out huge areas of skin and tissue. " You have to treat it like a cancer -

>

> excise and reconstruct, " Rosenberg said.

> Wolf recently performed Koebel's eighth reconstructive surgery.

> He is

> unable to remove the silicone entirely because it has grown into

> tissues,

> but Koebel says she's grateful she can at least come out of hiding now.

> She

> returns for steroid injections every several months to keep down the

> swelling - something she will have to do for the rest of her life.

> Ironically, she notes, the procedure she opted for to save money

> has

> ended up costing her tens of thousands of dollars in reconstructive

> surgery

> and lost earnings.

> But she says the worst part of the ordeal is that she doesn't

> really

> have sympathy of her family and friends.

> " People say, 'Well, she was vain, she got what she deserved,' "

> she

> said. " But I don't think anyone deserves this. "

>

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