Background and Aims

Plastic surgery procedures have been rising in the last few years. The morbi-mortality due to illegal use of biopolymers is a public health problem. One of the clinical consequences, Iatrogenic Alogenosis (IA), may be a precursor of ASIA syndrome.

The objective of this article is to present a case-series study of patients who developed ASIA syndrome following gluteal injection with biopolymers and emphasize the importance of environment factors and toxic exposure in triggering autoimmune responses. A surgical technique used on some of the patients in the study is described.

Methods

A group of thirteen patients, diagnosed with IA, who developed ASIA syndrome confirmed by approved criteria was followed (May 2016-May 2018). The “Butterfly Wings Technique,” a new surgical procedure for patients who have middle to severe compromise, was used on five of them.

A narrative literature review was done to look for subjects with ASIA syndrome and gluteal biopolymer infiltration.

Results

All the patients in the present case-series with IA developed ASIA syndrome. Most of them (9 patients) had a background of environmental factors and familial autoimmunity. Five of the patients were surgically treated and saw a clinical improvement after the extraction of the biopolymer with the proposed technique.

The narrative literature review identified 7 articles related to the disease through the database search.

Conclusions

We suggest that IA should be considered a precursor to ASIA syndrome. New research projects will be needed in the future to evaluate the factors that determine when ASIA syndrome is triggered in a patient with IA.