Patient has chest abscess after illegal filler injection in hotel

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A 26-year-old female patient living in Binh Tan District (HCMC) came to the Department of Dermatology, HCMC Dermatology Hospital for examination with both breasts, especially the right breast, swollen, red, and with pus.

The patient said that 3 weeks before, he went on Facebook and saw a Facebook account in Hanoi advertising a very "attractive" breast augmentation filler injection service with "eye-catching" images, so he contacted her. After that, the two parties agreed to go to Ho Chi Minh City to rent a hotel to perform breast augmentation filler injections.

After agreeing on the price and time, the filler injection staff went to Ho Chi Minh City and rented a hotel room to inject filler to enhance the patient's breasts and some other guests. In total, the staff injected 350cc of Korean body filler into the patient's breasts for 25 million VND.

“After the injection, both sides of my breasts were red and painful. When I contacted the staff, they said, “It’s okay, it’s a normal sign after the injection.” However, about a week before being hospitalized, my right breast was swollen, filled with pus, red and very painful. I called them and was instructed to take Zinnat, take Alphachoay and use warm water to roll on my chest. However, the condition did not improve but got worse, my right breast was redder and had more pus,” the patient shared.

At the Department of Dermatology, Ho Chi Minh City Dermatology Hospital, Dr. Le Thao Hien examined and noted that the patient's right chest was swollen, erythematous, had a large abscess, was tense, hot to the touch, and painful to press. The left chest also had a mass of similar size, not hot, red. Ultrasound results showed images of filler scattered in soft tissue, with a large abscess.

The patient was admitted to the hospital for inpatient treatment. After a few days, the abscess spontaneously ruptured, oozing a lot of pus and filler. The patient was treated with antibiotics, anti-inflammatory drugs and decided to have surgery to pump, wash, and curettage to remove the filler and pus.

The curettage and washing went smoothly. Plastic surgeons at the Ho Chi Minh City Dermatology Hospital removed a lot of pus and filler, then changed the bandage and cleaned the patient's wound daily.

According to Associate Professor, Doctor, Doctor Pham Hieu Liem, Head of the Plastic Surgery Department, Ho Chi Minh City Dermatology Hospital, because the filler has dissolved into the tissue, it must be treated many times. The consequences are that the patient's chest will have an ugly scar, the breast shape will be deformed, and there is a risk of new abscesses. In addition, the left breast is also at risk of infection and abscesses.

According to Dr. Thao Hien, filler is a filler used in the cosmetic industry, which has the effect of filling areas on the body, reducing wrinkles, and rejuvenating the skin. However, the US Food and Drug Administration (FDA) currently only approves filler injections in the face, neck, and hands. Other cases of filler injection (also known as body filler) are not approved by the FDA, including the chest area.

In addition, incorrect injection techniques, non-sterile environment and injection process are the causes of infectious complications and abscesses.

Injecting fillers to increase breast size has many potential risks such as embolism due to compression of blood vessels due to injecting too much, resulting in acute anemia leading to necrosis of the chest area; embolism due to injecting fillers into blood vessels, resulting in necrosis of the chest area and the most dangerous is that the fillers follow the blood vessels to nearby organs such as the lungs and heart, causing pulmonary and cardiac embolism leading to death.

In addition, breast abscesses due to multiple injection sites and non-sterile injection procedures, improper post-treatment care; inflammatory granulomas due to the body's allergic reaction to foreign objects (fillers); fibrotic scars due to substandard fillers remaining in the breast for a long time and thereby stimulating the formation of fibrous tissue surrounding them; skin pigmentation disorders, subcutaneous lumps due to too shallow injections.

In addition to abscesses and necrosis, breast augmentation filler injections can also cause anaphylactic shock (this is rare). The cause is due to the body's sensitivity to the ingredients in the filler. Mild cases can cause hives, severe cases can cause difficulty breathing, chest pain, and abdominal pain. Critical cases include hoarseness, rapid breathing, cyanosis, cold skin, low blood pressure, impaired consciousness, and coma.

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