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PARAFFIN OIL REMOVAL SURGERY Dr.Ruşer BARIŞ, Plastic,Reconstructive and Aesthetic Surgeon Dream Clinique, Ankara, Turkey Injection of foreign substances, such as paraffin oil, for the purpose of body contour augmentation has been used from the beginning of the last century. After severe destructive consequences of migrating parafin oil were recognized , the procedure has become obsolete in Western medicine. However, oil injections are still performed, either through self-injection or by unauthorised personnel. Adverse effects include skin inflammation, induration, sterile abscesses, fistulas, and skin rupture with suppuration of oily material(1). There are studies reporting complications after paraffin oil injections(2,3) Paraffin injection also cause anemia, renal insufficiency, and severe hypercalcemia. In fact hypercalcaemia is quite common, usually caused by hyperparathyroidism, malignancy, or sarcoidosis, and can be life threatening. Granulomatous foreign-body reactions are rare but important in differential diagnosis. Calcium is normally tightly regulated by parathyroid hormones and vitamin D, which is converted to the active form, 1,25-dihydroxyvitamin D (calcitriol), by CYP27B1. In granuloma-induced hyper calcaemia,  calcitriol production is catalysed by abnormal activity of CYP27B1 in inflammatory cells, particularly macrophages. This extrarenal activity does not appear to be regulated by classic feedback mechanisms, allowing calcitriol (and calcium ions) to rise to pathological levels(4). There […]