I want to remove hydrogel and PMMA. What can I do about this? (Photo)

I am truly sorry to hear of your concerns, especially as there is no good answer for you. In short, there is no way to remove the injected nodules of hydrogel or PMMA granules without destroying much of your buttocks tissue. The best analogy I can think of is asking a baker to remove the raisins from raisin bread without damaging the loaf. This cannot be done, which is why we are much less eager to inject foreign substances in patients' bodies.Sometimes the injected foreign substances become infected, painful, or cause firm and sore nodules of scar. Fortunately for you, this does not seem to be a problem (yet). Please leave well enough alone, and hope you develop no problems, as your surgeon will still have the same issue as outlined above. This is not a good situation, and avoiding it in the first place is no longer an option for you, but I thank you for asking so others may learn. Best wishes! Dr. Tholen

Thank you for your question regarding the removal of hyaluronic acid and PMMA injected into your buttocks four years ago. It's essential to have these substances removed, especially given that they are causing noticeable issues. You've described stage two symptoms, including discoloration and changes in the skin texture of your left buttock. Such reactions are not uncommon with injectables like hyaluronic acid, PMMA, and silicone.

Your body is attempting to reject these substances, which can lead to the symptoms you're experiencing. This reaction might cause these substances to migrate, potentially spreading up your back and down into your thighs, knees, calves, and ankles. They can even infiltrate your lymph nodes and pelvic region. Moreover, these substances can lead to systemic problems such as hypercalcemia, anxiety, and renal failure.

Given the potential risks, I strongly advise seeking immediate help from an experienced, board-certified plastic surgeon. Initial diagnostic steps might include a CT scan or an MRI to ascertain the location and extent of the injected substances. This information will guide the surgeon in determining the most appropriate surgical approach to remove these substances effectively.

Thank you for your question regarding the removal of hyaluronic acid and PMMA from your buttocks.

Sincerely,
Dr. Katzen

Our office is the leading center for the removal of foreign body fillers in the United States. My approach is protocol based, beginning with an examination to determine the grade of inflammation using the Karamanoukian Grading Scale for Soft Tissue Inflammation. Silicone biopolymers and PMMA can be safely removed from the face and body. Longterm complications are minimized with diligent attention to detail and protocol-based treatment. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Because removing injectables like PMMA and silicone is difficult (to completely remove all of it) and deforming (leaving unsightly scars and depressions/dents), it is typically recommended to wait until the patient is experiencing constant moderate to severe pain in a specific area and/or an infection arises. Glad to help. 

Silicone
Injections and Hydrogell Injections.Samir
Shureih MD. FACS.Baltimore,
Maryland.Buttock enlargement is
becoming a very popular cosmetic surgery procedure. There are several well
established surgical procedures that can safely accomplish that. These include
the Brazilian Buttock lift, Dermis Fat graft, and Buttock Implants.Some people have taken
advantage of this trend and use illegal, unsafe injections of non medical grade
Silicone, silicone oil and gel, Hydrogell, polyacrylamide, Macrolane and many
other unusual substances.Silicone injection to the
buttocks and other areas in the body are common underground illegal procedures.
The silicone used is industrial grade silicone oil bought from hardware store
or silicone oil used as a lubricant. This type of silicone is not pure and
contains many other substances. It is not a Medical Grade Silicone, if medical
grade silicone was to be used for buttock enhancement; it will be very
expensive and still not medically approved. The body reacts to the
foreign material by forming chronic inflammatory reactions called
SILICONE GRANULOMAS; these granulomas can be felt as hard lumps, sometimes
very painful. When injected near vital structures like nerves. The granulomas entrap
the nerve and cause pain, burning sensations, swelling, migration, blockage of
the lymphatic channels and skin color changes. The foreign injected material
can not be removed completelt. Granulomas can be removed in most cases but one
can not remove the entire injected material. Surgical removal will leave a
deformity that will have to be repaired at a later stage.