Why is there hardness 2 years after biopolymer removal surgery?

Question

2yrs now i had the bioploymer removal surgery, my question is why is my buttock stilll hard. I thought once the product was removed the tissue would soften?

Carlos Alberto Ríos García, MD · Answer

I understand your concern. Many patients expect the tissues to immediately become soft again once the biopolymers are removed, but unfortunately that is not always how these cases behave long term.
One important thing to understand is that the hardness is often not caused only by the product itself. Over time, biopolymers can trigger chronic inflammation, fibrosis, scar tissue formation, lymphatic changes, tissue thickening, and structural damage within the fat and surrounding soft tissues. Even after removal surgery, some of those tissue changes may persist.
In some patients, residual fibrosis or chronic inflammatory tissue can remain for years, especially if:
* the material was deeply infiltrated* there was extensive scar formation* the body developed a strong inflammatory reaction* or complete removal was not possible without damaging healthy tissues
It is also possible for residual product to remain microscopically or diffusely embedded within the tissues even after technically successful surgery, since these materials often integrate into fat, fascia, muscle, and connective tissue planes.
Without examination and imaging, it is impossible to determine whether the firmness is primarily due to scar tissue, residual inflammation, remaining material, lymphatic compromise, or a combination of factors.
Cases involving long-term fibrosis after biopolymer removal often require a very individualized evaluation because treatment decisions depend heavily on tissue quality, symptoms, circulation, skin condition, and whether the tissues are stable or still evolving over time.

Raffy Karamanoukian, MD, FACS · Answer

Chronic inflammation and fibrosis from silicone disease can induce granuloma formation and scar tissue. I would re-examine the area with ultrasound to determine the severity of your silicone disease to see if further rounds of removal can reduce the silicone burden. We specialize in this procedure in Los Angeles.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeremy S. Nikfarjam, MD · Answer

Hi Easygoing,
Did you have an open technique procedure? Did you have any reconstruction/ fat grafting to the buttocks after removal?There are a few possibilities- you could still have product in the buttock. Or you need some healthy, soft tissue coverage. Silicone disease is complicated (as I'm sure you well know) and whereas there are many similarities in cases, no two cases are alike. I'd recommend following up with your surgeon regarding the hardness of the tissue. He/she may order another MRI to determine whether or not a noteworthy amount of product remains. Or your surgeon may suggest some fat grafting if it hasn't been done so already. This is a journey and the good news is you're well on your way. Good luck to you!
Dr. Nik

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding hardness two years after your biopolymer removal surgery. This is not an uncommon problem. Before surgery, the hardness in the buttock is due to foreign body reaction and the creation of scar around the injected biopolymer. Your body identifies the biopolymer as a foreign substance, creating an inflammatory response. After the inflammatory response marks the biopolymer as a foreign object, scar tissue is created. The scar tissue become thicker and thicker until the biopolymer is removed. When the biopolymer and associated scar tissue was removed, the foreign body reaction was minimized. However, there is surgical scar creation due to the nature of the surgery. This is much softer than foreign body reactions to buy a polymer. In time the score tissue associated with biopolymer removal should decrease. I would suggest you be more thoroughly worked up with an MRI to determine that there is no residual biopolymer. If there is confirmation that there is no more or very minimal biopolymer left in the buttock, you may want to consider periodic episodic steroids doses Thank you for your question regarding buttock hardness two years after biopolymer removal surgery.

Why is there hardness 2 years after biopolymer removal surgery?

Answers (4)

More Silicone Injection Removal Questions

When my injections act up I’m prescribed steroids (prednisone). Is this helping or hurting me? I take a very low dosage.

Is silicone causing my leg muscles to atrophy?

Is it possible to remove silicone, hydrogel from the buttocks area with liposuction?

I'm a 73 years old woman and weight 140 pounds. Received silicone injections in 1969. Right breast is now deformed, options?

What's the downtime & side effects of removing silicone injection from my face? (Photo)

If I have no symptoms should I still remove silicone butt injections? (Photos)

WE SEND PRETTY
EMAILS