Breast Paraffinoma: A Case Report of 20-Year-Old Mineral Oil Injection in a Male Patient.

[BACKGROUND] Mineral oil injection represents a dated practice of rapid and inexpensive breast augmentation. After a latency period, surrounding tissue becomes inflamed and fibrotic. Breast paraffinoma is well-documented in women; however, only 3 cases of such masses in male patients exist in the literature.

[METHODS] We present a case of paraffinoma in a 63-year-old man from Puerto Rico who, desiring breasts, serially injected mineral oil into each breast daily for 13 years. Conservative management was initially attempted due to cardiac comorbidities and insurance authorization issues. The patient ultimately developed erosive wounds and therefore underwent excision of the bilateral breast masses as an en bloc specimen weighing 2.17 kg.

[RESULTS] Pathology indicated sclerosing lipogranulomatosis (paraffinoma). The quality of the wounds remaining warranted negative pressure wound therapy with serial debridement. The patient went on to successful reconstruction with a reverse abdominoplasty preserving periumbilical and intercostal perforators.

[CONCLUSIONS] Plastic surgeons must educate patients against using exogenous injected materials for augmentation of the breasts, penis, or buttocks. Although uncommon in the US, certain populations like body builders and foreign immigrants are at higher risk for current or prior injection practices. Reverse abdominoplasty is a viable reconstructive modality for the large resulting defect.