Medical Advisory Bulletin
22 August, 2003

Contact:

Gender Education & Advocacy, Inc.
P.O. Box 33724
Decatur, GA 30033-0724
http://www.gender.org/
dallas@gender.org
jamison@gender.org

This is an updated version of an advisory released in 1990, 1992, 1994 and 1996 by AEGIS, the American Educational Gender Information Service, Inc.

Silicone Use: Illicit, Disfiguring, Dangerous

The Problem

The injection of liquid silicone and other materials into human tissue is a problem of long standing in the U.S. and elsewhere around the world. Typically, silicone, often of industrial rather than medical grade and sometimes mixed with paraffin, oil, and other non-sterile materials, is injected under the skin, usually by individuals with no medical credentials, in settings such as apartments and bars. In pursuit of enhanced physical appearance, many individuals have repeated injections, with cumulative amounts reaching as much as 1.5 liters. Areas typically injected are cheekbones, lips, brows, chin, breasts, buttocks, calves, hips, thighs, pectoral area, and calves.

While appearance may be enhanced on the short-term, most silicone injection is ultimately disfiguring, as the silicone migrates, changes shape, or hardens. Once injected, silicone is impossible to remove completely, and extensive scarring accompanies even partial removal. Silicone injected in the breast area makes mammograms ineffective, and often requires radical bilateral mastectomy.

Since the 1960s, the U.S. Food & Drug Administration has repeatedly warned of the dangers of injected silicone, labeling it an illicit practice and warning that interstate transport of silicone is illegal.

Injected silicone can and often does result in a variety of medical problems. Documented reactions have included respiratory distress, infection, toxic shock syndrome, granuloma, scleroderma, cancer, neuropathy, lymphadenopathy, rheumatic symptoms, synovitis, and severe autoimmune and connective tissue disorders. Use of dirty needles places the individual at risk for HIV, hepatitis, and other infectious diseases. Medical problems may develop immediately upon injection, or years or even decades later, and can and can result in debility or death.

Despite the dangers of and long history of fatalities, disease, and disfigurement caused by silicone injection, the practice is still common, especially in Asian populations in the U.S. and broad and male-to-female transgendered and transsexual individuals in North and South America. Sex workers, individuals of lower socioeconomic status, amateur and professional female impersonators and club entertainers, and especially people of color may be most at risk. We have received anecdotal reports of silicone injection by female-to-male transsexuals and transgendered persons in the ball cultures of several East coast cities.

Advisory

Silicone injection is a dangerous, illicit practice that can and does disfigure and kill. It should be avoided by all transgendered and transsexual persons.

Those who wish to safely transform their bodies should consider other alternatives, such as transgender hormonal therapy, diet, exercise, clever use of cosmetics, prosthetics, or consultation with a plastic surgeon. A qualified plastic surgeon can be found by calling the American Society of Plastic Surgeons at 1-800-635-0635 http://www.plasticsurgery.org/.

Discussion

Silicone injection causes immediate changes in body contour, and that is its appeal. Cheeks, chins, breasts, buttocks, and other parts of the body are “pumped,” often in a series of injections. The “instant curves” which result are especially important to transgendered and transsexual persons, who may seek silicone injection for a variety of reasons: to make their bodies more pleasing to themselves; to enhance their ability to pass in public as a member of the non-natal sex; to make them more attractive to others; to enhance their marketability for sex work, or as female impersonators; and as a way to feminize their bodies without subjecting themselves to the effects of counter-sex hormones. Many transgendered and transsexual women who work in the sex industry see an advantage in maintaining their virility, as hormonal therapy will lower their libidos and cause in most the eventual loss of the ability to penetrate their male clients.

While the silicone injected is usually the inexpensive industrial-grade caulk sold at hardware stores, the price of being “pumped” is not cheap. One “treatment” can cost as much as $500, and dozens of “treatments” may be needed for the individual to achieve and maintain the desired appearance. While plastic surgery is not inexpensive, the dangers are minimal, the results are more enduring, and it is ultimately less expensive than repeated “pumping.”

Those who inject silicone operate clandestinely through an underground network of runners, who arrange dates, times, and locations for pumping sessions. Dozens of “clients” may be injected on a single afternoon. Runners use their own pumped bodies as advertisements, downplaying the inconvenience and dangers of silicone injection. Injectors “pump and jump,” leaving town immediately after their sessions; those who develop complications are on their own. Silicone injectors often operate near or as members of drag houses of the ball cultures in urban centers, with no police interference unless a death occurs from a silicone injection-- a tragedy which happens with some regularity. Due to the unsanitary practices of silicone providers, silicone injection is considered a likely means of transmitting HIV and Hepatitis B and C.

The dangers and unfortunate results of injected silicone are well-documented in the medical literature.

References

A note on injectable silicone. http://www.tsroadmap.com/early/silicone.html.

Chastre, J., Brun, P., Soler, P., Basset, F., Trouillet, J.L., Fagon, J.Y., Gilbert, C., & Hance, A.J. (1987). Acute and latent pneumonitis after subcutaneous injections of silicone in transsexual men. American Review of Respiratory Disease, 135(1), 236-240.

Dying for beauty: Silicone injections. (2001, 29 March). http://www.click10.com/mia/health/stories/health-56459820010329-110320.html.

Hage, J.J., Kanhai, R.C., Oen, A.L., van Diest, P.J., & Karim, R.B. (2001, March). The devastating outcome of massive subcutaneous injection of highly viscous fluids in male-to-female transsexuals. Plastic and Reconstructive Surgery, 107(3), 734-741.

Ohtake, N., Itoh, M., & Shioya, N. (1992). Postoperative disorders of augmentation mammaplasty by the injection method in Japan. In U.T. Hinderer (Ed.), Plastic surgery 1992, Vol. 2, pp. 677-678. New York: Elsevier.

Silicone injected at parties in South Florida: Health Department calls it an epidemic. (2001, 29 March). http://www.click10.com/mia/news/stories/news-56479220010329-130339.html.

Also On This Website:

Silicone Injection: A Comprehensive Bibliography
A lenghty list of publications and articles on the dangers of injected silione.

“Dangerous Curves Ahead” Public Service Announcement
The original public service announcement as put out by AEGIS, Inc.

Cheekbones From Hell, or Injectable Silicone: Bad News
More information, including vignettes based on experiences of actual people with injected silicone.

Pómulos del infierno o La silicona inyectada: ¡Malas noticias!
Más información, incluyendo anécdotas de personas reales sobre sus experiencias con silicona inyectada.

Gender Education and Advocacy (GEA) is a 501(c)(3) nonprofit corporation which serves as a clearinghouse for information about transgender issues. GEA maintains the website http://www.gender.org/, which is the organization’s main tool for information dissemination. GEA is the successor organization of the American Educational Gender Information Service.