Advertisement

Complications following liquid body contouring with site-enhancing oil injections

  • Author Footnotes
    1 DO and NK share first authorship.
    ,
    Author Footnotes
    2 Doha Obed: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval, agreement to be accountable for all aspects of the work
    Doha Obed
    Correspondence
    Corresponding author. Doha Obed, MD, Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
    Footnotes
    1 DO and NK share first authorship.
    2 Doha Obed: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
    Search for articles by this author
  • Author Footnotes
    1 DO and NK share first authorship.
    ,
    Author Footnotes
    3 Nicco Krezdorn: analysis and interpretation of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Nicco Krezdorn
    Footnotes
    1 DO and NK share first authorship.
    3 Nicco Krezdorn: analysis and interpretation of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
    Search for articles by this author
  • Author Footnotes
    4 Elissa Harik-Chraim: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Elissa Harik-Chraim
    Footnotes
    4 Elissa Harik-Chraim: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
    Search for articles by this author
  • Author Footnotes
    5 Christian Freystaetter: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Christian Freystaetter
    Footnotes
    5 Christian Freystaetter: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
    Search for articles by this author
  • Author Footnotes
    6 Christine Radtke: critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Christine Radtke
    Footnotes
    6 Christine Radtke: critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
    Search for articles by this author
  • Author Footnotes
    7 Peter M. Vogt: critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Peter M. Vogt
    Footnotes
    7 Peter M. Vogt: critical revision of article, final approval, agreement to be accountable for all aspects of the work
    Affiliations
    Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
    Search for articles by this author
  • Author Footnotes
    1 DO and NK share first authorship.
    2 Doha Obed: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval, agreement to be accountable for all aspects of the work
    3 Nicco Krezdorn: analysis and interpretation of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    4 Elissa Harik-Chraim: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    5 Christian Freystaetter: acquisition of data, critical revision of article, final approval, agreement to be accountable for all aspects of the work
    6 Christine Radtke: critical revision of article, final approval, agreement to be accountable for all aspects of the work
    7 Peter M. Vogt: critical revision of article, final approval, agreement to be accountable for all aspects of the work

      Abstract

      Liquid body contouring by intramuscular injection of site-enhancing-oils (SEOs) for muscle volume enlargement has increasingly become a popular practice in bodybuilding. Its immediate and long-term health consequences remain ambiguous and post-injection complications are sparsely documented in the medical literature.
      Here we report a series of patients presenting with post-injection complications upon self-attempted liquid body contouring through injection of SEOs. Ten patients visited our departments for plastic and reconstructive surgery for variable local and systemic complications. All patients showed a history of single or multiple SEO use and presented on average nine years post-injection with variable complications. Most patients experienced painful nodular indurations and swellings in the injected target muscles. Two patients showed signs of infection including erythema, elevated body temperature and local inflammatory symptoms. One patient presented additionally with a severe form of non-parathyroid hypercalcemia. Four patients ultimately underwent surgical treatment. The use of SEOs for liquid body contouring is a dangerous practice and is associated with potentially systemic and life-threatening complications. Surgical treatment may be the only therapeutic option in advanced cases and should be performed timely. Guidelines on diagnostic and therapeutic measures are warranted. Educational measures should be undertaken to raise awareness among athletes and medical professionals.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinics in Dermatology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Glicenstein J.
        Les premiers « fillers », vaseline et paraffine. Du miracle à la catastrophe.
        Annales de Chirurgie Plastique Esthétique. 2007; 52: 157-161
        • Pupka A
        • Sikora J
        • Mauricz J
        • Cios D
        • Płonek T.
        The usage of synthol in the body building.
        Polim Med. 2009; 39: 63-65
        • Banke I
        • Prodinger P
        • Waldt S
        • et al.
        Irreversible Muscle Damage in Bodybuilding due to Long-Term Intramuscular Oil Injection.
        International Journal of Sports Medicine. 2012; 33: 829-834
        • Munch IC
        • Hvolris JJ.
        Body building aided by intramuscular injections of walnut oil.
        Ugeskr Laeger. 2001; 163: 6758
        • Ghandourah S
        • Hofer MJ
        • Kießling A
        • El-Zayat B
        • Schofer MD.
        Painful muscle fibrosis following synthol injections in a bodybuilder: a case report.
        Journal of Medical Case Reports. 2012; 6
        • Sisti A
        • Huayllani MT
        • Restrepo DJ
        • et al.
        Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature: Upper Extremity Injections for Cosmetic Enhancement.
        Acta Bio Medica Atenei Parmensis. 2020; 91e2020082
        • Prosperi-Porta G
        • Oleynick C
        • Vaughan S.
        Myositis from intramuscular oil injections in a bodybuilder.
        Canadian Medical Association Journal. 2020; 192: 480
        • Figueiredo VC
        • da Silva PRP
        Cosmetic Doping—When Anabolic–Androgenic Steroids are not Enough.
        Substance Use & Misuse. 2014; 49: 1163-1167
        • Gitz-Johansen G
        • Als AB
        • Pallesen KAU
        A case of severe side effect due to muscle oil injections in combination with chemotherapy in a former bodybuilder.
        Clin Case Rep. 2021; 9: e04444
        • Petersen E
        • Lee K
        • Yao C
        • Jahan-Tigh R
        • Thomas V.
        No pain no gain: tender nodules in a competitive bodybuilder.
        Dermatol Online J. 2018; 24: 13030
        • Fink J
        • Schoenfeld BJ
        • Hackney AC
        • et al.
        Anabolic-androgenic steroids: procurement and administration practices of doping athletes.
        Phys Sportsmed. 2019; 47: 10-14
        • Hall M
        • Grogan S
        • Gough B.
        Bodybuilders’ accounts of synthol use: The construction of lay expertise online.
        J Health Psychol. 2016; 21: 1939-1948
        • Brennan R
        • Overbye M
        • Van Hout MC
        • McVeigh J.
        A slippery slope”: a scoping review of the self-injection of unlicensed oils and fillers as body enhancement.
        Performance Enhancement & Health. 2021; 8100185
        • Hameed M
        • Sahu A
        • Johnson MB.
        Muscle mania: the quest for the perfect body.
        BMJ Case Rep. 2016; bcr2016217208
        • Khanna P
        • Khatami A
        • Swiha M
        • Rachinsky I
        • Kassam Z
        • Berberich AJ.
        Severe Hypercalcemia Secondary to Paraffin Oil Injections In A Bodybuilder With Significant Findings on Scintigraphy.
        AACE Clinical Case Reports. 2020; 6: e234-e238
        • Pehlivanov G
        • Kavaklieva S
        • Kazandjieva J
        • Kapnilov D
        • Tsankov N.
        Foreign-body granuloma of the penis in sexually active individuals (penile paraffinoma).
        J Eur Acad Dermatol Venerol. 2008; 22: 845-851
        • Ahmed U
        • Freeman A
        • Kirkham A
        • Ralph D
        • Minhas S
        • Muneer A.
        Self injection of foreign materials into the penis.
        annals. 2017; 99: e78-e82
        • Sølling ASK
        • Tougaard BG
        • Harsløf T
        • et al.
        Non-parathyroid hypercalcemia associated with paraffin oil injection in 12 younger male bodybuilders: a case series.
        European Journal of Endocrinology. 2018; 178: K29-K37
        • Gyldenløve M
        • Rørvig S
        • Skov L
        • Hansen D.
        Severe hypercalcaemia, nephrocalcinosis, and multiple paraffinomas caused by paraffin oil injections in a young bodybuilder.
        The Lancet. 2014; 383: 2098
        • Visnyei K
        • Samuel M
        • Heacock L
        • Cortes JA.
        Hypercalcemia in a male-to-female transgender patient after body contouring injections: a case report.
        J Med Case Reports. 2014; 8: 71
      1. Di Benedetto G, Pierangeli M, Scalise A, Bertani A. Paraffin Oil Injection in the Body: An Obsolete and Destructive Procedure: Annals of Plastic Surgery. 2002;49:391-396.

        • Ikander P
        • Nielsen AM
        • Sørensen JA.
        Injection of synthol in a bodybuilder can cause chronic wounds and ulceration.
        Ugeskr Laeger. 2015; : 177
        • Iversen L
        • Lemcke A
        • Bitsch M
        • Karlsmark T.
        Compression bandage as treatment for ulcers induced by intramuscular self-injection of paraffin oil.
        Acta Derm Venereol. 2009; 89: 196-197