Could a patient get a butt implant at the same time as excision surgery for silicone removal?

Question

If not, I was hoping to learn more information in regards to why. Additionally, How long after a successful excision surgery would a patient be able to get a buttock implant OR a BBL? does the timeline differ for either type of reconstructive surgery?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you could safely undergo buttock augmentation at the same time as silicone removal. Is very unsafe and unwise to place a buttock implants at   the same time as raw silicone removal. You must understand that the silicone that was injected was non-medical grade and was not sterile. After the non-sterile silicone injections (butt shots), your body creates scar tissue around the silicone to wall off any potential infection. Injected silicone is very prone to infection. 
Therefore, if you disturb the injected silicone, there is a high chance of an infection and wound breakdown during the surgical removal of silicone. Therefore, it is very unwise to put a butt implant, which is very    prone to infection even without the presence of silicone. If you have silicone butt injections and you are having these injections removed and you are thinking about a buttock implants, this is a “perfect storm” or “recipe for disaster”  and sets you up for a very high chance of buttock implants infection and then, rejection. The same goes for fat transfer or BBL performed at the same time as buttock silicone removal. The best thing to do is to have your buttock silicone removed and wait a minimum of four months before buttock reconstruction.  Before any reconstruction is attempted, the silicone must be completely    removed.   The FDA warns AGAINST silicone injections on their website.  The FDA states “Do not get injectable silicone or any type of filler material for large-scale body contouring or enhancement.” Also, the FDA has said Injectable silicone is permanent, with side effects that can occur right after the injection and up to years after treatment. Silicone spreads and migrates easily inside the body, which may worsen adverse events and make surgical attempts to remove the silicone oil more difficult or impossible. Silicone, when injected into areas with many blood vessels such as the buttocks, can travel to other parts of the body and block blood vessels in the lungs, heart, or brain. This can result in permanent damage to those tissues and lead to stroke or death.”  I specialized in silicone buttock removal and subsequent buttock reconstruction.  I am the Director and chief clinical investigator at the Institute of Silicone Removal.  Since removing silicone from the buttock is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone from the buttock.  Do your research.  Make sure they have performed at least 100 buttock 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, buttock silicone removal surgeon in your neighborhood, consider traveling out of state if you must. I hope that I have answered your questions regarding getting butt implants at the same time as excision surgery for buttock silicone removal.  Sincerely, Dr. Katzen. (“Verified” 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 and RealSelf Hall of Fame.)

Jeremy S. Nikfarjam, MD · Answer

Hi LA-Girl,
I've performed several hundred silicone removal surgeries and my strong belief is that removal and reconstruction should occur in two separate stages. This silicone product causes tissue and fat necrosis which is what leads to many of the symptoms patients experience after silicone injection. The product itself is hard and non-porous and then the body creates small, hard scar capsules around the product. Sitting on this day after day slowly depletes the blood supply to the healthy tissue causing that necrosis. One needs a healthy blood supply in order for the fat to "take" and survive the transfer. Additionally, many of these illegal injections occur in a non- sterile setting which increases the likelihood of infection (current or future). Grafting or implanting something should only be done in the "cleanest" (bacteria free) environment to ensure a good outcome. 
Most of my patients have their reconstructive procedure (essentially a BBL) approximately 6 weeks after their removal procedure. Both procedures are often covered by a patient's health insurance policy. 
I wish you luck in your search for treatment!
- Dr. NIk

Kenneth Hughes, MD · Answer

Hello, thank you for your question. I am having to do more and more of these debulking procedures before patients can have butt implants. The type of removal depends on the type of substance, the amount of surface area involved, and the patient desires. The material is removed in the first stage. It is rare that over 50% of the material can be removed. Because the material is typically laden with bacteria means that you run the risk of injection and recurrence of granulomas. A period of 3 months or so is observed. Reconstructive surgery can be performed later to improve the appearance. To help allay fears and eliminate worries of patients who made the previous poor decision to have these substances injected, I recommend that they consult with a board certified PS who has experience in removing silicone.

Jaime Pachon, MD · Answer

the reason why it is not possible is because of the risk of activation of the Asia syndrome. It is never advisable to put a foreign body when there is a biopolymer in a tissue, particularly with implants associated with biopolymers there is a high risk of metaplasia and dysplasia in the compromised tissues. the only possibility of gluteal fat transfer is to present negative tests for ASIA syndrome and a withdrawal greater than 80% of the product.

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