American Association of Plastic Surgeons

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Surgical Management of Biopolymer Induced Hypercalcemia and Renal Insufficiency: A Case Series
Dieter Brummund, MD1, Camilla Quinones, MD2, Angela Chang, MD3, Christopher Salgado, MD2
1Larkin Community Hospital, Pinecrest, FL, USA, 2Constructive Surgery Associates, Miami, FL, USA, 3University of Miami, Miami, FL, USA

PURPOSE: Biopolymer injections with liquid silicone and foreign bodies can trigger a granulomatous reaction leading to calcitriol mediated hypercalcemia and renal insufficiency over time. This case series describes the successful resolution of hypercalcemia and biopolymer induced renal insufficiency through the surgical debridement of granulomatous tissue.
METHODS: A retrospective chart review was done on patients undergoing biopolymer debridement by the senior author from 2019-2023.
RESULTS: Eight patients were included in this study. Preoperative and postoperative markers showed a statistically significant reduction in serum calcium from 10.07 mg/dL preoperatively (range 7.6 - 13.6 mg/dL ) to 8.77 mg/dL post operatively (range 8.3 - 9.7 mg/dL ) with a p value of 0.049. Markers showered a statistically insignificant reduction in serum creatinine from 1.25 mg/dL preoperatively (range 0.61 - 4.5 mg/dL) to 0.89 mg/dL (range 0.45 - 2.8 mg/dL) with a p value of 0.11. All patients were women with an average age of 51 (range 38-60). Six patients had previous biopolymer injections in the buttocks (75%) and two patients had previous buttock augmentation with silicone implants (25%). The average time since biopolymer exposure was 15 years (range 10 - 30 years). The most frequent complications were wound dehiscence (2, 25% ) and seroma (2, 25%). No surgical site infections were encountered in the study. Patients required an average of 1.7 operative interventions (range 1-5). No patient progressed to end stage renal disease requiring dialysis.
CONCLUSION: This case series suggests that surgical resection of biopolymer or foreign body granulomas may reduce serum calcium.


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