I have illegal silicone injections in my butt and I’m willing to travel to get them removed. What is the best method to do so?

Hello, Thank you for your questions about how to remove illegal silicone butt injections.  There are 2 accepted ways to remove silicone from the buttock.  If you have minimal amounts of silicone injected, minimal scar tissue, minimal skin changes, or minimal pain, I usually suggest ultrasound assisted VASER liposuction for silicone removal.  If you have moderate to significant amounts silicone injected, moderate to severe scar tissue, moderate to severe skin changes, or moderate to severe pain, I usually suggest an incision across the top of the buttocks to directly excise silicone and associated scar tissue.  Without pictures or a physical examination, it is difficult to determine which silicone removal procedure you will need.  A consultation with an experienced, board-certified plastic surgeon is in order.  As you have found sometimes, it is difficult  to find a local expert.  Therefore, I would suggest you travel out of state to find such a silicone removal expert.  A large percentage of my patients come from other states.  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 Teagen and thank you for your question. As a board certified plastic and reconstructive surgeon in New York, I have treated hundreds of patients suffering from acute and systemic issues related to illegal silicone and biopolymer injections since I started my residency training in the Bronx. First and foremost, you are not stupid, you are not alone, and I applaud you on taking the first step by doing your research on how to best address the complications you are experiencing as a result of these illicit injections. I find that a majority of patients with whom I consult and treat for silicone and biopolymer injection removals are actually victims of cosmetic predators who likely lied to, ignored and/or talked around of the real risks associated with these illicit injections before offering you and performing these illicit services.
To answer your question, it is my professional medical opinion that the best and only effective means of silicone and biopolymer injection removal is via a staged surgical excision of the silicone/biopolymer product and the scar and granulomatous tissue that results from these injections. In my private plastic and reconstructive surgery practice (New You Plastic Surgery), I perform these staged surgeries utilizing a patients insurance benefits at state of the art local area hospitals with a specialized and dedicated silicone removal care team. I do not believe (as evidenced by my time in the operating room) that this product can be effectively removed with any type of liposuction removal - simply put, the product cannot be effectively 'suctioned' - which is why I recommend and perform a two-stage surgical excision removal protocol.
At New You Plastic Surgery, my dedicated silicone removal patient coordinators handle every facet of the pre-operative workup, surgical scheduling, logistics coordination, and post-operative care coordination. We offer virtual and in-person consultations and a fly in program for all of our out of town patients.
After doing your research, be sure to schedule a consultation with only board certified plastic surgeons who specialize and are well-versed in this very specific and specialized procedure - of which there are only a handful, including myself, in the country. I hope that this helps and that you know that you are not alone in this and there are options for you! I wish you all of the best and I am happy to talk further should you have any follow up questions. Dr. Nik.

Silicone biopolymers are being used throughout the world for facial and body volume augmentation. Results are longer-lasting that Juvederm or Restylane. 
Bellafill and Artefill are known to cause granulomas and permanent nodules with swelling. This is not the case for everyone. Silicone biopolymers can also cause similar chronic inflammatory conditions. 
In my practice, I specialize in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. 
Silicone biopolymers can also be removed from the body if there are signs of migration or inflammation. All of these filler-types should be removed as early as possible. 
Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

You are correct; many surgeons will refuse to operate on patients because there is more intrinsic risk in operating on a patient who has non-sterile injections of unknown material or illegal silicone. I remove the material in the first stage.  You will probably need 3 months or so after removal for observation. It may not be possible to remove all of the material due to lack of visibility, injection into the muscle or more deeply, etc. This removal inevitably creates contour deformities, which can be difficult to correct with fat grafting. A BBL can be performed after you have healed.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA