Foreign modeling agent reaction; managed with two staged surgical reconstruction. Case report and review of literature

INTRODUCTION: In Mexico, body modeling with injectable biomaterials such as liquid silicone is a common practice in non-certified clinics by non-medical personnel; These materials produces a series of complications described as Foreign modeling agent reaction (FMAR) with variable spectrum of severity. CASE PRESENTATION: 38-year-old female with history of biomaterial injection in a non-certified cosmetic clinic 10 years prior to evaluation. Presents with intermittent symptoms characterized by fever, erythema, induration and pain in the gluteal region. An exhaustive debridement and resection with primary closure was performed. Thereafter, reconstruction was done using a combined technique with gluteal implants and autologous fat graft, evolving without complications. DISCUSSION: The use of biomaterials has been widely documented throughout history; liquid silicone being one of the protagonists. Used for aesthetic purposes and modeling areas such as buttocks and breasts. They have been associated with an assortment of early or late onset complications, sometimes resulting in fatal outcomes. Various treatment modalities have been described depending on the severity of presentation, from conservative to surgical management. CONCLUSION: There is a shortage of treatment guidelines regarding FMAR due to its wide variety of presentation, treatment must be individualized to obtain adequate results. Although conservative treatment has shown good results, the anatomical alterations usually condition dissatisfaction that should be addressed with reconstructive techniques [10].