Inflammation from silicone injection?

Question

I had silicone injections done 15 years ago and now I'm experiencing inflammation and some crepey skin on my buttock. I believe it has migrated some to the areas around. I currently don't have health insurance and while I try to figure out what is my best option, meanwhile is there any antibiotics recommended that I can get prescribed to help with reducing the itchy, inflammation that I'm experiencing mainly on my buttock?

J. Timothy Katzen, MD, FACS · Answer

Hi Misslay, Thank you for your question regarding inflammation from silicone injections. Thank you for
your history. Your inflammation is probably due to your injected silicone. Silicone should not
be injected. The FDA has issued warnings against using silicone for large tissue augmentation.
Over time, silicone can cause ASIA syndrome, can migrate, and can cause an inflammatory
response. This inflammatory response can present itself as pain, redness, swelling, and
inflammation. Over time, the inflammatory response can cause fibrosis, scarring, and
granuloma formation. Silicone can cause a host of auto-immune problems like Hashimoto's
thyroiditis and arthritis. The best treatment is the surgical removal of the silicone and
associated scar tissue. Injection or ingestion of steroids may decrease the inflammation and
pain, however taking steroids is only a temporary solution. Antibiotics are also temporary and
only treat the infection and not the cause, namely the silicone. Therefore, treat the cause and
have the silicone removed. I hope this helps to answer your question about whether this is "inflammation from silicone injection".
Sincerely, Dr. J. Timothy Katzen, MD

Jose Telich, MD · Answer

Dear Misslay, late inflammation after silicone injections is unfortunately a known complication, even many years after the procedure. The body can react to the silicone as a foreign material, leading to chronic inflammation, firmness, pain, redness, or changes in the overlying skin such as crepiness.

Antibiotics are not a definitive treatment for silicone-related reactions and shoul only be prescribed in case of infections by a medical provider. Inflammation can sometimes be managed using steroids but they should be administered carefully.

It’s very important to consult a plastic surgeon experienced in biopolymer removal or a dermatologist familiar with foreign body reactions. They can evaluate the extent of the inflammation and determine whether medication, imaging, or surgical intervention is necessary.

Jeremy S. Nikfarjam, MD · Answer

Hi Misslay!

I'm really sorry you're experiencing worsening symptoms—it’s unfortunately not uncommon to start having issues like inflammation, skin changes, or migration many years after silicone injections. You're right to be cautious and to start thinking about managing symptoms while figuring out a long-term plan. A few key things first: Itchy, inflamed, crepey skin can be caused by chronic low-grade inflammation, granuloma formation, or even infection around the silicone. If it’s migrating or you’re seeing changes beyond just skin (like nodules, swelling, or warmth), that might signal something more active than simple irritation. Without imaging or a clinical exam, it's hard to tell if there’s an actual infection versus a sterile inflammatory reaction (which is more common).

Regarding antibiotics:
While I can't prescribe, I can tell you what’s typically used in cases like this if a doctor deems antibiotics appropriate:

1. Minocycline or Doxycycline which can be prescribed by your primary care physician if he/she is aware of your injection history. These are often used more for anti-inflammatory effects rather than true infection. They're prescribed in granulomatous silicone reactions and can calm down symptoms like swelling, tenderness, and itchiness;

2. Clindamycin which sometimes used if there's more concern for infection (especially anaerobic coverage);

3. Bactrim DS -Occasionally used if your provider suspects a bacterial component like a low-grade abscess.
*Please note - for foreign body inflammatory response (most common), then these antibiotics won't "cure" it—they just help settle the immune response for a while.

Over-the-counter / non-prescription support:
NSAIDs (like ibuprofen or naproxen) can reduce inflammation and discomfort.

Topical steroids (like hydrocortisone 1%) might help a bit with the itch if it's superficial.

Cold compresses can reduce flare-ups temporarily.

Long-term:
Ultimately, if the silicone is triggering immune reactions or migration, surgical removal (excision) is the most definitive fix. I know you said you're uninsured right now, but if you're in the U.S., some low-cost imaging (like ultrasound) at a community health center might help you understand how extensive the issue is (can also be ordered by your primary care physician).

Although Medicaid based plans do not cover silicone removal, we've had great success at my Silicone Removal center here in New York with commercial PPO plans which could be something to look into. To discuss further, please call to schedule a complimentary virtual or in person consultation. My silicone coordinator can go over the insurance aspect and help guide you in the right direction.

Best of luck on your silicone removal journey. We're here to help if you need us!

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers are commonly used in the face and body. They may sometimes cause noticeable symptoms that we gauge using the Karamanoukian Soft Tissue Reaction Grading Scale from I to V. The severity of your complications dictates the interventions needed, ranging from itching and burning to severe necrosis of the soft tissue. Nerve pain and symptomatic swelling is also possible. Insurance may cover your surgery, but that is a discussion that requires you to contact and appeal to your insurance carrier. Options for removal are complex and depend on whether you have the material in your face or body. We reverse BBL with silicone commonly and remove silicone from the lips very commonly. Diffuse silicone in the face is not likely to respond to removal. Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. We can also test for the material to determine the likelihood of silicone granulomas and silicone reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Darryl J. Blinski, MD · Answer

Without posted photos, hard to recommend but usually I start treatment plan with a combination of antibiotics and steroid for this issue plus recommend an MRI or ultrasound of buttocks. Plus a virtual or in person consultation to discuss exactly what’s going on. Most likely will need some type of surgical intervention with reconstruction. This is not an insurance covered option. Again, virtual consult with.

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