Classification of Foreign Body Reactions due to Industrial Silicone Injection

BACKGROUND A foreign body reaction (FBR) is a typical tissue response to a biomaterial that has been injected or implanted in human body tissue. There has been a lack of data on the classification of foreign body reaction to silicone injection, which can describe the pattern of body tissue responses to silicone. OBJECTIVE Determine the foreign body reaction to silicone injection. METHOD We modified the classification proposed by Duranti and colleagues, which has categorized a FBR to hyaluronic acid injection into a new classification of an FBR to silicone injection. A cohort study of 31 women suffering from silicone-induced granulomas on their chin was conducted. Granulomatous tissue and submental skin were stained with hematoxylin–eosin and evaluated. RESULTS Our data revealed that there were at least 7 categories of FBRs to silicone injection that could be developed. Categories 1 to 4 showed inflammatory activity, and categories 5 to 8 showed tissue repair by fibrosis. CONCLUSION Using histopathological staining, we are able to sequence the steps of body reactions to silicone injection. Initial inflammatory reaction is then replaced by fibrosis process repairing the damaged tissues. The process depends on the host immune tolerance. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Address correspondence and reprint requests to: Ago Harlim, MD, MHA, PhD, Head of Dermatology and Venereology Division, Medical Faculty, Christian University of Indonesia, Fakultas Kedokteran Universitas Kristen Indonesia, Jl. Mayjen Sutoyo No. 2, RT5/RW11, Cawang, Kramatjati, Jakarta Timur, Jakarta 13630, Indonesia, or e-mail: agoharlim@yahoo.com The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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