A Route To Beauty That's Cheap, Fast, and Possibly Deadly

Posted Apr 17, 2009 by Joan Firstenberg
In a quest to look more beautiful, women are spending money on getting silicone injections from unscrupulous practitioners. The process may be cheap, but the outcome can be lethal.
Chemical Silicone Mixture
Chemical Silicone Mold Mixture
Eric Mackey
Fiordaliza Pichardo had been getting silicone injections from a woman she met through a friend in order to plump up her thighs and derriere. She liked the deal she was getting, and oh what a deal it turned out to be. One day in March, after receiving injections, the 43-year old Pichardo, died of what a medical examiner later determined was a silicone embolism in her lungs.
The New York City health department is concerned that the illegal use of silicone as an alternative to cosmetic surgery is on the rise. The city’s poison control center has received three calls in the last 10 months from doctors who have treated patients injected with silicon. In the previous two years, there were only two such cases.
Health department officials worry that there may be other cases that have gone unreported, since doctors are not legally bound to report silicone poisoning or even death, and since silicone is hard to detect through X-rays or CT scans.
The practice is growing on a nationwide level. The Food and Drug Administration is planning to issue a warming on silicone uses.
Doctors say silicone is not approved for injection into tissues at all, only for use in the eyes and in certain implants where it is contained and cannot leak into tissue. They say the F.D.A. had the ability to conduct criminal investigations, and would encourage victims to come forward “so that we can document the problem.” Across the Internet, chat rooms, Web sites and blogs have sprung up discussing buttock injections.
The victims have become caught up in an underground beauty industry that uses injections of black-market, medical-grade silicone or industrial-grade silicone as a cheap, fast and easily accessible way to plump up breasts, buttocks, thighs and even wrinkles.
The injections are particularly popular among Latina women and trans-gender women, who may be unable to afford conventional plastic surgery and who tap into it through unlicensed practitioners working through word of mouth.
Although side effects are fairly rare, silicone can migrate through the bloodstream, creating potentially fatal clots in the lungs, as it did in Ms. Pichardo’s case, said Dr. Nathan M. Graber, director of environmental and occupational disease epidemiology for the New York City Department of Health and Mental Hygiene. It can also migrate through tissues, leading to ugly lumps and chronic pain.
The injections are administered at home, in motel rooms, in makeshift offices or at “pumping parties,” where the guests take turns injecting one another, officials said.
Young trans-gender women often seek out silicone injections because they are a quick way of making bodies more feminine, unlike hormone treatments, which may take years to work, said Dr. Nick Gorton, an emergency room doctor who treats trans gender patients at the Lyon-Martin Health Services clinic in San Francisco. He says it's gotten out of control.
“If you go to a pumping party, you can have it tonight. It’s a big temptation, especially among young people who, when you’re 20, you’re not thinking about your own mortality.”
People are often reluctant to report side effects, because they feel that they are turning in a member of their community, health officials said.
Industrial-grade silicone can be bought at a hardware store. But doctors say there have been reports of the use of substitutes like Castor oil, mineral oil, petroleum jelly and even automobile transmission fluid.
Dr. Suhail Raoof, chief of pulmonary medicine at New York Methodist Hospital, treated a woman with silicone poisoning in 2007. She came in complaining of shortness of breath, chest pain and coughing, reminiscent of pneumonia, he said, and told doctors that she had been injected with about 500 milliliters of silicone in each buttock about half an hour earlier.
Because silicone is not visible on an X-ray or a CT scan, physician diagnosis is difficult without a biopsy. Doctors used deduction to diagnose the cause of the woman’s symptoms, and she survived.
Ms. Pichardo was not so lucky.
Ms. Pichardo’s 19-year-old daughter, Marinés Rodriguez, said that her mother began getting silicone injections several years ago after a friend introduced her to a cosmetologist.
Ms. Rodriguez said the cosmetologist went to Ms. Pichardo’s home in the Bronx and to other clients in Manhattan and Miami. A cup of silicone cost $800, and the cosmetologist would inject half a cup to two cups in a single session, Ms. Rodriguez said.
Her mother “didn’t really care about the price. It was more that she knew somebody who had this first. She felt that was her friend, nothing could go wrong,”
Ms. Pichardo was last injected on March 17, and died the next day. Doctors thought she had pneumonia, Ms. Rodriguez said, and the family never thought to mention the silicone injections — which were discovered during the autopsy — because they thought they were harmless.
The medical examiner has ruled her death a homicide because she was injected by an unlicensed non medical practitioner, said Ellen Borakove, a spokeswoman for the medical examiner. No charges have been filed. Paul J. Browne, a police spokesman, said,
“We believe she has fled to the Dominican Republic and we are in discussions with the district attorney as to next steps.”