Hi VadaVitale, Thank you for your question regarding biopolymer removal for someone with silicone injection shots and BBL, and how can this be done? Basically, there are two methods of silicone, biogel, biopolymer, or PMMA removal, even with a BBL. There are two techniques: the closed technique and the open technique. The closed technique involves injection of tumescent fluid, application of the VASER (to break up scar tissue around the silicone), and then suction to remove the silicone and associated scar tissue or granulomas. Three pencil eraser-sized incisions are made: one at the top of the buttock crack and two under each buttock cheek. During the open technique, an incision is usually made across the top of the buttocks, from the top of the buttock crack to the hips. Some people call this a lazy M, sea gull, or McDonald's sign incision. Tissue dissection is carried to the gluteus maximus muscle and down the fascia. Then a large butterfly area of silicone, granulomas, and scar tissue is removed. Then, the buttock is lifted and the incision is closed. Before any surgery is contemplated, a consultation is needed. An MRI is required to determine the amount and location of silicone and whether it is in the muscle. If the silicone is in the muscle, you would do best with the open technique. If the product is only in the fat, the closed technique may be possible. The recovery for the closed technique is about 2-3 weeks. The recovery for the open technique is about 3-4 weeks. Advantages of the closed technique include smaller scars and faster recovery. The disadvantages of the closed technique are limited removal of silicone and no buttock lift in the end, just deflation. The open technique allows for more silicone and scar tissue removal, as well as a buttock lift during surgery. Disadvantages of the open technique include a longer incision and longer recovery. Both procedures are performed under general anesthesia. Both procedures require drains for several days or weeks. Recovery from the closed technique is on your back; recovery from the open technique is flat on your abdomen. Neither procedure is covered under insurance. Most plastic surgeons do not perform a BBL or butt reconstruction at the same time as silicone removal. To obtain an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. Since removing silicone is a major procedure, please seek an experienced, board-certified plastic surgeon who has significant experience in silicone removal. Do your research. Make sure they have performed many silicone removal surgeries and have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. If you cannot find an experienced silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA (Plastic Surgeon, President of the American Society of Bariatric Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, Director and Chief Clinical Investigator at the Institute of Silicone Removal, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel, Director and Chief Investigator of the Silicone Removal Institute.)
