In short
- 🚨 There is a serious, uncommon picture with a high mortality after injection of liquid silicone: silicone embolism syndrome. It presents with pneumonitis, alveolar haemorrhage and respiratory distress.
- It can appear within hours. And it can add neurological symptoms: confusion, altered consciousness, seizures.
- 🔑 It is a clinical diagnosis that depends on you saying so. Without the history of the injection, A&E looks in a different direction.
- ⚠️ It is not the same as a vascular occlusion from hyaluronic acid. That is a local problem in the area; this affects the whole body, and it is not treated with hyaluronidase.
- The lungs are a known target organ. Among the published cases of industrial silicone, pulmonary complications appear in 34.5%.
- Infection counts too. Fever, spreading redness or discharge in the area do not allow waiting.
- There is no standardised treatment, so time and the right diagnosis are the only things working in your favour.
If you have had a filler injected hours or days ago and you are short of breath, coughing, have chest pain, a fever or feel confused, go to A&E now and say you have been injected with a product. Do not wait until tomorrow, do not call whoever injected you first, do not look for more information.
The rest of this page explains why, and what to say when you get there.
This page is about the first hours and days. If yours is material injected years ago, what applies is symptoms and warning signs.
🚨 When to go to A&E, without hesitating
If you have had a product injected in the last few days and any of this appears:
- Shortness of breath or rapid breathing.
- A cough, especially if it persists or brings up blood.
- Chest pain.
- Fever.
- Confusion, abnormal drowsiness, difficulty speaking or a seizure.
- Skin in the area that is pale, mottled, very painful or darkening.
- Discharge, spreading redness or swelling that grows quickly.
You do not need to have all of them. One alone, in that context, is already reason to go.
What silicone embolism syndrome is
It is the most serious acute complication described after injection of non-medical liquid silicone, and it is worth understanding because it explains why the urgency is real.
When liquid silicone is injected into tissue, some of the material can pass into the bloodstream and reach the lung. What happens there is described in the literature as a picture of pneumonitis, alveolar haemorrhage and acute respiratory distress syndrome.
These are the published cases that describe it best:
- A 28-year-old woman, previously healthy, presented with new-onset seizures and acute respiratory distress after a recent silicone injection in the gluteal region. The admission was complicated by altered consciousness, respiratory failure and rapid haemodynamic deterioration, and the patient died.
- Another case describes severe silicone pneumonitis complicated by respiratory distress and bilateral pneumothorax after gluteal augmentation with silicone.
The authors of the first case sum it up in three sentences worth bearing in mind:
- It is a clinical diagnosis that depends on a careful history and a detailed examination.
- The documentation on this phenomenon is limited and the medical treatment is not standardised.
- Morbidity and mortality remain high.
What you do with that information is not to panic: it is to go early and to say so. Because of the three, the only one you can influence is the first.
Why it matters so much that you say so
Here is the useful part of the whole page.
A young, healthy woman arriving at A&E with breathing difficulty and seizures does not fit any obvious diagnosis. Infection is considered, an epileptic seizure, an embolism from another source. And all those hypotheses lead to tests and treatments that are not the problem.
The one piece of information that reorders everything is a single one: “I was injected with something X days ago, in this area”.
And that is precisely the hardest thing to say, because often the procedure was clandestine, or was done in another country, or the person fears being judged. It is worth saying clearly: in an emergency, keeping quiet can cost you the diagnosis, and nobody is going to treat you worse for having said it.
What to say, specifically:
- What you were injected with, even if all you know is “a filler” or “a silicone” or not even that.
- In which area.
- How long ago.
- Who did it, if you know, and whether it was at healthcare premises or not.
What this is NOT
It is worth separating from another urgent picture that resembles it in name and in nothing else.
| Vascular occlusion from filler | Silicone embolism | |
|---|---|---|
| Typical material | Hyaluronic acid and other aesthetic fillers | Liquid silicone, frequently industrial |
| Where it shows | In the area: pale or mottled skin, disproportionate pain, visual disturbance | Throughout the body: the lung and sometimes the nervous system |
| What is done | A specific urgent protocol, which may include hyaluronidase | Hospital A&E: respiratory support and management of the picture |
If yours was hyaluronic acid and the problem is local, the page that explains it is vascular occlusion from hyaluronic acid, where the detail of why timing changes everything sits.
Hyaluronidase does not resolve a silicone embolism. It is neither the same material nor the same problem.
The lungs, a known target organ
The lung being affected is not an anecdotal rarity.
- In the scoping review on the use of industrial liquid silicone, pulmonary complications appeared in 34.5% of published cases. (That is a proportion among published cases, not the incidence among everyone injected: that denominator does not exist.)
- A review specifically on the pulmonary effects of silicone implants and injections describes two types of vascular complication — acute and chronic embolisation syndromes, with a clinical and radiological presentation of alveolar haemorrhage — as well as inflammatory complications such as siliconoma, which can mimic a mesothelioma. That same review notes that asthmatic patients appear to be at greater risk of adverse effects.
Put another way: if you have asthma and have been injected, there is one more reason to seek advice early with any respiratory symptom.
And if the first few days have already passed
Then this is no longer an immediate emergency, but it still deserves assessment. A chronic embolisation picture is also described, and late complications have a page of their own: symptoms and warning signs.
And if what you want is to know what you were given and what can be done, that starts with an imaging scan and is set out in the guide to biopolymer removal.
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Frequently asked questions
I was injected today and I have a cough. Should I go to A&E?
Yes. A cough and difficulty breathing in the days after a filler injection are grounds for urgent assessment, and silicone embolism syndrome presents precisely with pneumonitis and alveolar haemorrhage.
How long does it take to appear?
It can be quick: there are described cases in which the picture developed within hours of the injection. A chronic, later form has also been described.
And if I am embarrassed to say where I had it done?
That is understandable and it is the biggest obstacle to the diagnosis. This picture is diagnosed clinically and depends on the history: if you do not say so, they look in another direction. Nobody is going to treat you worse for saying it.
Does hyaluronidase help?
Not for this. Hyaluronidase acts on hyaluronic acid, not on silicone or other permanent materials.
Is it common?
No, it is uncommon. But among the published cases of industrial silicone, pulmonary complications account for 34.5%, and the mortality of this particular picture remains high, so the mismatch between how rare it is and how serious it can be justifies seeking help.
I have asthma — does that change anything?
It may. A review of the pulmonary effects of silicone notes that asthmatic patients appear to be at greater risk of adverse effects. It is one more reason to seek advice early.
Is there a treatment?
There is no standardised treatment; what is done is support and management of the picture in a hospital setting. That is why time and the right diagnosis matter so much.
I was injected in a private house. Will I be reported if I say so?
What happens in A&E is that you get treated. Healthcare does not depend on where you had it done, and the information they need is clinical, not for the police. If you later want to make a claim, that is a separate process: it is in reporting and making a claim.
Sources
- Lin C, Robison J. Silicone Embolism Syndrome Causing Altered Mental Status and Respiratory Failure After an Unlicensed Gluteal Silicone Injection: A Case Report. Clin Pract Cases Emerg Med. 2024;8:151-154. A previously healthy 28-year-old woman who presented with new-onset seizures and acute respiratory distress syndrome after a recent cosmetic procedure involving silicone injections in the gluteal region; the hospital course was complicated by altered mental status, respiratory failure and rapid haemodynamic deterioration, with a fatal outcome; the authors describe silicone embolism syndrome as a picture characterised by pneumonitis, alveolar haemorrhage and respiratory distress, note that it is a clinical diagnosis depending on a careful history and examination, that documentation of the phenomenon is limited, that medical management is not standardised and that morbidity and mortality remain high. https://pubmed.ncbi.nlm.nih.gov/38869340/
- Ng BH, Mat WRW, Abeed NNN, Hamid MFA, Yu-Lin AB, Soo CI. Silicone pneumonitis after gluteal filler: a case report and literature review. Respirol Case Rep. 2020;8:e00538. Silicone embolisation syndrome can progress rapidly to pneumonitis as a consequence of injecting non-medical-grade liquid silicone; a case is described of severe silicone pneumonitis complicated by acute respiratory distress syndrome and bilateral pneumothorax following gluteal augmentation with silicone. https://pubmed.ncbi.nlm.nih.gov/32076554/
- Simon E, Pahus L, Chanez P. Pulmonary adverse events of breast silicone implants and silicone injection. Respir Med Res. 2023;84:101065. A review of pulmonary adverse effects of breast implants and silicone injections: the overall prevalence of adverse effects is around 20%, while the true incidence of pulmonary ones is unknown; the vascular complications are represented by acute and chronic embolisation syndromes with a clinical and radiological presentation of alveolar haemorrhage; among the inflammatory ones is siliconoma, a granulomatous reaction that can mimic mesothelioma; the authors also note that some subpopulations appear to be at greater risk, in particular asthmatic patients. https://pubmed.ncbi.nlm.nih.gov/38042060/
- Gerk A, Telles L, Carroll M, et al. Use of industrial liquid silicone: a scoping review. Acta Cir Bras. 2024;39. Among the published cases of industrial liquid silicone use, the most frequent complications were granulomatous reaction (41.5%), dermatological problems (41.5%), infection (35.9%) and pulmonary complications (34.5%). https://pubmed.ncbi.nlm.nih.gov/39383418/
Book your consultation
This page is not asking you to book an appointment: it is asking you to go to A&E if you recognise yourself in it.
Once the acute picture is resolved, then the other conversation makes sense: what you were given, how much there is and what can be done about it. That is assessed in the consulting room and starts with an imaging scan.
Clinical confirmation by the surgeon
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
