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From: " ilena rose " <ilena@...>

Sent: Tuesday, June 05, 2001 5:58 PM

Subject: Skin Deep ~ Dangerous Beauty

> http://www.msnbc.com/news/576924.asp

> (click here and get the photos and voice)

>

> June 4 - When Kris Koebel heard about a cosmetologist who offered

> inexpensive injections that could permanently plump lips and erase

wrinkles,

> she immediately made an appointment, thinking the rejuvenation would give

a

> boost to her acting career. But after eight rounds of reconstructive

surgery

> to repair the damage resulting from the shots of silicone, the 45-year-old

> Miami woman, who used to perform on Broadway and cruise ships, says her

> career is over.

>

> THE SILICONE - which was injected into her lips and the tiny lines that

were

> beginning to radiate around her mouth - created a hard ball on her upper

> lip. Within a few months, the entire lip area had ballooned to five times

> its normal size, so that it protruded past the end of her nose.

>

> " I looked like a duck from the side - people thought I had been severely

> punched, " she said.

>

> The quest for beauty has turned ugly for many in South Florida. Thousands

of

> women and men are buying into promises of fuller lips, smoother skin and

> made-to-order measurements by untrained, unlicensed practitioners wielding

> syringes of liquid silicone, state health officials report.

>

> And the practice - which has been linked to severe disfigurement and even

> death - appears to be spreading to other areas of the country, from South

> Carolina to Southern California.

>

> For fees ranging from $100 to $500, cosmetologists, travelling South

> American pseudo-doctors and even house cleaners illegally inject liquid

> silicone - an oily fluid similar to the gel used inside silicone breast

> implants - into customers' wrinkles, lips, breasts, buttocks, legs and

hips.

>

>

> The immediate effects can be pleasing - smoother thighs, tauter cheeks,

> sexier pouts - but the long-term results can be far from beautiful.

>

> " Imagine the biblical description of leprosy, " said Dr. Rosenberg, a

> plastic surgeon in Delray Beach, Fla., who has seen about 20

> silicone-injected patients in the last two years. " Their faces look like

> they are melting. They have boils and abscesses. "

>

>

> In at least one case, the consequences of the practice have gone beyond

> disfigurement. In March, Vera Lawrence, a 53-year-old Miami secretary and

> mother of two, died after she received injections of silicone into her

> buttocks and hips, allegedly from a house cleaner. The medical examiner

> recorded the cause of death as silicone embolism, caused when the thick

> fluid traveled to one of her lungs. This was the first such case recorded

in

> Florida but doctors say silicone injections have likely resulted in other

> deaths by blocking blood vessels or leading to other damage.

>

> Dr. no Busso, a dermatologist in Coconut Grove, Fla., and clinical

> instructor of dermatology at the University of Miami, also blames the

> injections for severe bruising, recurring infections, nerve damage,

chronic

> inflammation and painful tumor-like lumps. " It is crazy to do this, it's

an

> extremely unsafe procedure, " he said.

>

> 'OPERATION HOT LIPS'

>

> A year and a half ago, the Florida Health Department's Office of

Unlicensed

> Activity created a task force dubbed " Operation Hot Lips " to take on the

> underground cosmetic injection industry. The investigation has yielded 14

> arrests, according to chief investigator Enrique .

>

> " We've just begun to scratch the surface, " he said. " It's an epidemic in

> Florida. "

>

> Most recently, Ruiz, who police suspect of injecting silicone into

> customers from her home near Miami for years, was arrested last month for

> practicing medicine without a license after a WTVJ/NBC 6 undercover

> investigative report tipped off the authorities. The case is currently

> awaiting trial.

>

> A woman who asked that she not be identified said she was left with lumps

> under her eyes and distorted lips after she received a series of

injections

> from Ruiz.

>

> " She said it was the latest thing from Europe, that not a lot of people

knew

> about it and it was being tested in the United States, " the woman recalled

> of Ruiz's sales pitch.

>

> The woman, a former model, says she feels so self-conscious about her

> " disfigurement " that she seldom leaves her house. She receives regular

> cortisone injections to reduce the swelling but doctors refuse to remove

the

> silicone for fear of causing further damage.

>

> " I just want my face back, " she said.

>

> says the practice is so widespread in South Florida because it's

the

> gateway to South America, where silicone injections are widely used. The

> practice first gained a foothold in Florida among the foreign-born

> population, but it quickly crossed social, economic and racial lines.

>

> " I've seen it in the poorest neighborhoods and in affluent Palm Beach, "

> said.

>

> The practice has gained a following among AIDS patients who use it to

plump

> up faces that have grown gaunt from anti-retroviral drugs - a side effect

of

> the drug regimen is redistribution of body fat that can result in sunken

> cheeks. Transsexuals are also major consumers, using large volumes of it

to

> create feminine curves.

>

> FROM FLORIDA TO CALIFORNIA

>

> The practice is not restricted to Florida. The house cleaner arrested in

the

> death of Lawrence is suspected of running a silicone injection service for

> transsexuals in Greenville, S.C.

>

> Dr. Wolf, a Miami plastic surgeon, says he has treated patients who

> say they were injected in California, New York and New Jersey.

>

> " Florida is where this has been exposed because it's so rampant, " he said.

> " This is just the tip of the iceberg - within a year we're gonna find it

all

> over the country. "

>

> --------------------------------------------------------------------------

--

> ----

>

> " The Price of Beauty "

> WTVJ's investigative report " The Price of Beauty " first uncovered the

> underground silicone injection industry in South Florida. The piece, which

> originally aired Feb. 15, 2001, led to the arrests of two unlicensed

> practitioners.

>

> --------------------------------------------------------------------------

--

> ----

>

>

> THE LURE OF A QUICK FIX

>

> says clients are seduced by cut-rate prices and the promise of

> permanency. The effects of approved cosmetic injectables like collagen are

> short-lived because they are natural substances that the body absorbs

after

> a few months.

>

> Koebel, who was injected by a Brazilian cosmetologist at the woman's

> apartment, said for $300 it sounded like a good deal: " That's less than

> collagen and you have to do that every three months, " she recalled

thinking.

>

> But Dr. Malcolm , president of the American Society for Aesthetic

> Plastic Surgery and clinical assistant professor of plastic surgery at the

> University of California, Irvine, warns women: " You just might get what

you

> wish for. It'll be permanent but then when there are problems you won't be

> able to get rid of it. "

>

> " People want a cheap, quick fix and don't even think about the

> consequences, " Wolf said.

>

> The trouble, Busso says, is that no one can predict who will have a bad

> reaction. He estimates the complication rate at somewhere around 10

percent

> - " outrageous " for a cosmetic procedure.

>

> Unpredictable effects may take years to appear, or can arise almost

> immediately. The area of the body where the silicone is injected can swell

> to grotesque proportions. " I've seen lips that look like hot dogs sitting

on

> a face, " Busso said.

>

> In other cases, the silicone can migrate, causing reactions in other parts

> of the body. Just before talking with MSNBC, for example, Busso consulted

> with a patient whose silicone had migrated from her cheeks down to her

jaw,

> where it formed an unsightly lump.

>

> But the result most dreaded by plastic surgeons is the chronic

inflammatory

> reaction, in which the body's immune system recognizes the silicone as a

> foreign body and mounts an all-out war against it. Large pockets of scar

> tissue can form around the silicone, creating tumor-like bulges that can

> continue to grow larger and larger, Busso said.

>

> The reaction is similar to that experienced by some women whose silicone

> gel-filled breast implants leaked or ruptured - migration of the gel with

> lumps of scar tissue forming around it, according to the Food and Drug

> Administration.

>

> With liquid silicone, the body's craze to get rid of the substance can

> trigger sudden swelling, pain, redness and fever, Busso said. " Not long

ago,

> I had a patient who had to be admitted to a hospital eight years after

being

> injected. Her face suddenly blew up like a balloon, turned red like a

tomato

> and she had a fever of 103. She had to get [intravenous] antibiotics and

be

> put on steroids, " he recalled.

>

> SILICONE SOIREES

>

> The underground silicone network operates on word of mouth, said.

> Both Koebel and the unnamed woman were referred for silicone injections by

> aestheticians at beauty salons.

>

> Clients go to back-room clinics, private homes and hotel rooms for the

> procedure. Some practitioners even host " silicone parties. "

>

> " Some are real high class, offering Cristal [champagne], " said.

>

> The champagne may be expensive, but the hygiene is Third World.

said

> the seizure of one practitioner's bag revealed dog hair, candy remnants

and

> used needles. He suspects some of the practitioners are even reusing

needles

> - adding AIDS and hepatitis to the list of possible complications of

> silicone injections.

>

> The silicone's purity is doubtful. Often called " biopolymer " in the

> underground industry, patients often don't even know what substance they

are

> having injected, noted.

>

> He says some of it is medical silicone brought in from outside of the

> country, illegally; but often it's industrial-grade silicone - the type

used

> in paints and lacquers or to coat automobile parts. It may not even be

> silicone at all - Wolf says he has seen a patient with injected paraffin

> that left her face " hard as a rock. "

>

> Doctors say contaminants in non-medical silicone can cause potentially

> deadly reactions and horrific recurring infections. Rosenberg notes the

> industrial silicone may also contain carcinogenic materials.

>

> " People are playing Russian Roulette, " said.

>

> HISTORY OF CONTROVERSY

>

> Cosmetic silicone injections have a controversial past. After World War

II,

> the shots became popular among Japanese women who would use liquid

silicone

> to augment their breasts. In the 1960s, the practice became popular among

> strippers in the United States.

>

> The results were disastrous: hardened, lumpy painful breasts, with some

> women requiring mastectomies.

>

> Liquid silicone was never actually approved for any medical use during

that

> time, but the FDA overlooked the practice until the early 1990s when it

> issued a ban on injecting the substance.

>

> Silicone gel breast implants also were banned for cosmetic use in 1992,

when

> their makers could not prove their safety to the FDA's satisfaction.

> However, silicone implants remain an option in some medical cases - for

> breast reconstruction after a mastectomy, for example - and for women

> enrolled in clinical trials.

>

> But in 1994 a liquid silicone product was approved by the FDA for treating

> detached retinas. That opened an avenue for doctors to begin using liquid

> silicone for cosmetic injections again: Once a drug or device is approved

by

> the FDA, doctors can use it as they see fit. Currently, there are two such

> products on the market for eye surgery.

>

> Dr. Orentreich, a dermatologist at the Orentreich Medical Group in

New

> York City - and son of Dr. Norman Orentreich, who helped pioneer cosmetic

> injections of silicone - currently uses the approved ophthalmologic

silicone

> as a wrinkle, scar and lip filler.

>

> However, the American Society for Aesthetic Plastic Surgery opposes

cosmetic

> silicone injections because they are not FDA-approved, according to ,

> the society's president.

>

> Wayne , president of , the developer of Silikon 1000,

> one of the silicone products approved for eye surgery, said his company

does

> not want physicians using their product for off-label purposes.

>

> But the company will begin FDA-approved clinical trials at the end of this

> month on a new formulation designed specifically for cosmetic injections

> into facial wrinkles.

>

> expressed concern that the illegal activities in Florida may spark

> unfounded fears about legitimate medical uses of silicone. " Silicone is a

> very misunderstood substance - you can't just fill a syringe and inject

it.

> The results can be quite disastrous if it's not done properly, but

labeling

> silicone as poison is ridiculous. "

>

> He points out that silicone has been used successfully for years in many

> medical devices, from the coating on needles that allows them to slide

> through the skin, to artificial joints, catheters, shunts and heart valves

> made of solid silicone rubber.

>

> PICKING UP THE PIECES

>

> After the charlatans skip town, Florida's plastic surgeons and

> dermatologists are often left to pick up the pieces. " Someone who is doing

> this in the back of a beauty parlor or in a hotel room is not likely to be

> there for you when you have a problem, " said Wolf, adding that he sees

> several victims of the fad every week.

>

> Removing the silicone is nearly impossible and often involves carving out

> huge areas of skin and tissue. " You have to treat it like a cancer -

excise

> and reconstruct, " Rosenberg said.

>

> Wolf recently performed Koebel's eighth reconstructive surgery. He is

unable

> to remove the silicone entirely because it has grown into tissues, but

> Koebel says she's grateful she can at least come out of hiding now. She

> returns for steroid injections every several months to keep down the

> swelling - something she will have to do for the rest of her life.

>

> Ironically, she notes, the procedure she opted for to save money has ended

> up costing her tens of thousands of dollars in reconstructive surgery and

> lost earnings.

>

> But she says the worst part of the ordeal is that she doesn't really have

> sympathy of her family and friends.

>

> " People say, 'Well, she was vain, she got what she deserved,' " she said.

> " But I don't think anyone deserves this. "

>

>

> Return next Monday for Skin Deep Part 2: Why some cosmetic surgeons are

> seeking the return of silicone breast implants.

>

>

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