Unraveling Silicone Catastrophe: A Case of Surgical Management and Reconstruction in the Gluteal Region.

Silicone injections, often administered by unlicensed practitioners, can lead to severe complications, including chronic inflammation, fibrosis, and tissue destruction. This case report describes the surgical management of a 43-year-old woman with extensive silicone infiltration into the gluteal region, including subcutaneous tissue and bilateral gluteus muscles. The patient presented with severe pain, inability to sit, firm induration of the gluteal region, and discoloration. The patient's condition was managed through a carefully planned surgical approach that used reconstructive ladder principles and incorporated the patient's unique anatomy to achieve optimal outcomes. After dissecting down to the gluteal muscles, the foreign bodies and nonviable tissues were removed. Less than 10% of the gluteal muscle was removed. Reconstruction involved bilateral lumbosacral and posterior thigh fasciocutaneous flaps to restore function and aesthetics. The procedure improved the cosmesis and symptoms of the patient without compromising ambulatory function. This report highlighted the technical challenges and reconstructive strategies in managing advanced silicone complications.