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Massive subcutaneous emphysema after carbon dioxide mesotherapy.

Wenceslao M Calonge, Drahoslava Lesbros-Pantoflickova, Marina Hodina

Aesthetic Plastic Surgery

|January 9, 2013

Summary

A woman experienced severe abdominal pain after carboxytherapy, revealing a large subdermal gas bubble. This rare migration and coalescence of injected gas highlights a potential complication of carboxytherapy.

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Area of Science:

Medical Case Reports
Aesthetic Medicine
Gastroenterology

Background:

Carboxytherapy, a cosmetic procedure involving subcutaneous carbon dioxide injections, is generally considered safe.
Potential complications, though rare, can include pain, bruising, and infection.
Understanding the anatomical spread of injected gases is crucial for diagnosis and management.

Observation:

A 43-year-old female presented with acute right upper quadrant abdominal pain.
CT imaging revealed a large subdermal gas bubble extending along the flank and anterior abdominal wall.
The patient had undergone carboxytherapy on her thighs the day prior to symptom onset.

Findings:

The gas bubble was attributed to the migration and coalescence of carbon dioxide injected during carboxytherapy.
Prophylactic antibiotics were administered due to patent injection tracts observed on CT.
Complete gas resorption occurred within 10 days, but dysesthesias and muscle contracture persisted for 3 weeks.

Implications:

This case highlights an unusual complication of carboxytherapy: extensive subdermal gas migration.
The findings underscore the importance of considering recent cosmetic procedures in the differential diagnosis of abdominal pain.
Further investigation into the mechanisms of gas migration and coalescence in carboxytherapy is warranted.