Is lipo a bad way to get butt injections removed?

Hello, Thank you for your questions regarding the removal of illegal silicone butt injections. Presently, there are two accepted surgical procedures to remove illegal silicone buttock injections. To effectively remove illegal silicone buttock injections, there is ultrasound-guided VASER buttock liposuction and direct buttock excision.  Buttock silicone removal with liposuction is one option. However, removal of silicone with liposuction ALONE is difficult at best.  It is difficult to remove the silicone because there is sometimes very thick, reactive scar tissue around the silicone. A skilled plastic surgeon must penetrate this scar tissue to effectively remove the injected silicone.  Also, the surrounding scar tissue should be removed.  First of all, traditional liposuction cannulas cannot penetrate this thick reactive scar tissue around the silicone. Additionally, traditional liposuction cannulas cannot remove the scar tissue and thick silicone.  Over the years, I have made modifications to the procedure to optimize the removal silicone with liposuction. The procedure is now called ultrasound guided, VASER liposuction.  During one surgery, I do three key essential steps.  The first step is the detection and isolation of the silicone. This is achieved by using an ultrasound in the operating room during the surgery. Most of the plastic surgeons order a pre-operative MRI. The problem is during surgery, things move and a pre-operative MRI is not as accurate as an intraoperative ultrasound.  The second step that I use includes using a VASER liposuction cannula to melt the scar tissue around the previously injected, illegal silicone.  This helps to liquefy the scar tissue.  The third step is that I use a custom made, proprietary, large bore liposuction cannula to directly remove the illegal silicone, scar tissue, and early granuloma tissue.  These three steps are essential for successful removal of illegal buttock silicone. It is my belief that if you omit any of these steps, you will not obtain successful results.The following is a quick rundown of ultrasound guided, VASER liposuction for silicone removal. Pros: small incisions for liposuction access, quicker recovery than direct excision, no drainsCons: some residual and microscopic silicone maybe left behindIndications: patients with small isolated areas of silicone, patients with a relatively soft buttock, patients with mild to moderate scar tissue secondary to silicone injections, patients who cannot “deal" with a large incisionProcedure: takes approximately 2 to 3 hours depending on the amount of silicone and is performed under general anesthesia.Recovery: 1 to 2 weeks
Buttock silicone removal with direct excision is another alternative.  Depending on where the silicone is located, there are multiple incisions that can be placed. Typically, an incision is placed across the top of the buttock. This is done in a gull wings shape. Usually, the upper third to upper half of the buttock skin, silicone, scar tissue, and fat are directly removed. Other incisions can be placed depending on where the silicone is located.  The length of the incision depends on the amount of silicone that needs to be removed.  The following is a quick rundown of direct silicone removalPros: a large amount of silicone can be removed, direct visualization Cons: large incision, drains, longer recovery compared to ultrasound guided, VASER liposuction, some residual silicone that is not in the excision maybe left behindIndications: patients with large areas of silicone deposits, patients with a moderate to hard buttock, patients with moderate to severe buttock scar tissue secondary to silicone injectionsProcedure: takes approximately 4 to 5 hours depending on the amount of silicone and is performed under general anesthesia.Recovery: 2 to 3 weeks
I hope that I have answered your questions removing silicone from the buttock.   Before you make any decisions regarding silicone removal from the buttock, I would suggest you seek consultation with an expert. Please seek an experienced, board-certified, plastic surgeon.  Travel out of state if you must to find such a silicone removal  expert. If you have any more questions regarding silicone removal from the buttock, intra-operative ultra-sound guided VASER assisted liposuction or plastic surgery in general, please contact my office.  Sincerely, Dr. Katzen(Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, American Academy of Cosmetic Surgery, and Fellow of American College of Surgeons and American Board for Metabolic and Bariatric Surgery, Awardee: RealSelf 100.)

Hi 3rickki and thank you for your question. I am glad to hear that you are not experiencing any complications related to your silicone buttock injections and I hope that this continues to be the case! As a board certified plastic and reconstructive surgeon who specializes in silicone biopolymer injection removal surgery, it is my professional medical opinion that liposuction (laser or not) is an ineffective and dangerous method of removal. In fact, I have seen patients in consultation who had undergone failed removal surgery via liposuction whose symptomatology and complications worsened after liposuction and actually caused the product to migrate further.
As evidenced in the operating room and video included below, the illicit silicone biopolymer buttock injection material cannot be effectively removed via suction technique. The best and most effective method of removal is by a staged surgical excision where not only the illicit material is removed, but the compromised soft tissue, scar tissue and granulomatous tissue is removed as well.
If you have not done so already, I would encourage you to schedule a consultation with a board certified plastic and reconstructive surgeon who specializes in silicone biopolymer removal surgery. Many surgeons, like myself, offer in person and virtual consultations - at which time your concerns, medical history, goals and approaches for removal can be discussed at length. I would be happy to discuss the options for removal with you further or answer any other questions that you might have.
I hope that this helps and I wish you all of the best. Dr. Nik

Silicone removal is a necessity if there is chronic inflammation of the soft tissue. Removal may take several sessions to help reduce the density of foreign material. Best, Dr. KaramanoukianRealself100 Surgeon