Silicone injection removal - how can I start the process?

Question

I need guidance, looking to start the process of silicone injection removal. I had one round of silicone butt injections back in 2007. Luckily I have not experienced serious issues yet but I would like to start the process of removal ect. I have no idea what the first step is but I am ready to make start the process asap. Please help, any guidance is greatly appreciated. Thank you

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding how to start the process of silicone injection removal. I'm glad to hear you're taking proactive steps to address this, especially given the complexities involved with silicone injections.

The first step in addressing silicone removal is thorough research. Look for a board-certified plastic surgeon who specializes in the removal of silicone injections. It's crucial to find someone with extensive experience in this specific area, as the procedure can be complex depending on the extent of the silicone and its location.

Once you have identified a few specialists, the next step is to book a consultation. Many surgeons offer online consultations, which can be a convenient way to discuss your situation without needing to travel. During this consultation, the surgeon will likely discuss your medical history, the details of your silicone injections, and any symptoms you're experiencing.

Typically, an MRI is ordered to assess the area of injection—whether it’s the breasts, buttocks, face, or thighs—and to check for areas of silicone migration. The MRI helps to determine the amount of silicone present and its anatomical location, which are critical factors in planning the appropriate surgical approach.

If surgery is deemed necessary, you will need to attend a physical consultation where preoperative evaluations, including labs, an EKG, and possibly a chest x-ray, will be performed to ensure you are fit for surgery. Based on these findings and the complexity of the silicone removal, the surgery will be scheduled.

Each surgery is tailored to the individual's specific needs, with varying procedure lengths and recovery times. Therefore, these timelines are highly individualized.

In summary, the first step is diligent research to find the right specialist. The second step is to undergo a thorough consultation and diagnostic process. Once these steps are completed, your chosen surgeon will guide you through the preparation and execution of the silicone removal procedure.

Good luck as you begin this important journey toward resolving the issues caused by silicone injections.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Jeremy S. Nikfarjam, MD · Answer

Hi Vegas1087!

Thank you for sharing that—you're absolutely taking a powerful first step by looking into this now, even if you're not having serious issues yet. Planning early for silicone injection removal can help preserve your long-term health and give you peace of mind. Here’s a clear guide on how to start the process:

1. Find a Qualified Surgeon
You want a board-certified plastic surgeon who specializes in silicone or biopolymer injection removal, particularly from the buttocks. This isn’t a typical cosmetic surgery—it requires experience with: Identifying free silicone migration, managing scar tissue and inflammation; reconstructive techniques.

2. Schedule a Consultation
At the consultation, the surgeon will: Review your injection history (what was used, where, how much—if known), perform a physical exam; order imaging (usually MRI with silicone protocol). It's important to be honest and detailed, even if you don’t have full records. Your transparency will help guide safe removal planning.

3. Get Imaging (MRI with and without contrast)
MRI with silicone protocol: To assess how deep and widespread the silicone is, including possible migration to lymph nodes or muscle. This step is crucial for safe surgical planning.

4. Discuss Removal Options
Based on imaging and your anatomy, the surgeon will explain: What areas they can remove silicone from and if they offer (or are experienced with) reconstruction post silicone removal. It's also important to discuss: Recovery time and risks along with personal goals.

*Don’t rush into surgery with just any provider—this is delicate work that requires true expertise. Be cautious of anyone offering “minimally invasive” or “liposuction only” solutions for silicone removal; these often leave silicone behind or worsen inflammation.

My silicone coordinator would be happy to discuss further. She, too, has had silicone injection removal and reconstruction. I am a board-certified plastic and reconstructive surgeon with a specialized focus on silicone and biopolymer removal. Over the years, I have dedicated my practice to safely addressing complications arising from these materials. Recognizing the unique challenges they pose, I developed a two-stage surgical excision process along with a reconstructive phase. This approach is designed to ensure the most complete removal possible while minimizing risks and optimizing patient outcomes. If you're interested in scheduling a complimentary consultation either virtually or in person, please give us a call (516) 279-2616.

Best of luck with 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

Great question. No posted photos though? First step is to obtain an MRI or ultrasound of your buttocks to see if the injected illegal silicon has migrated. Next step is to try and find experience board, certified plastic surgeons, which are very few in USA, to advise you examine you either in person or virtually and offer you the potential options for removal and revision reshaping of your buttocks. Regards

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