Hello, thank you for your question regarding what happens if you never get buttock silicone removed which a previously been injected illegally into your buttocks. There are many patients who do not have any symptoms in regards to the silicone that was previously injected into their buttocks. These are the fortunate few. However, most patients over time will develop problems. Since the injected silicone is a foreign body and a potentially infectious source, your body makes scar tissue around each tiny ball of silicone. Since your body cannot dissolve the silicone, the scarring becomes chronic. The scarring can become excessive and lead to a very hard, dense butt. The chronic buttock scar tissue and then turn into a granuloma. The silicone stimulated buttock scar tissue can become very painful. The buttocks can become very painful when doing activities or when you are not doing anything and just laying in bed. The illegal silicone injection buttock scar tissue and then further surround nerves and lead to localized back and leg pain. In addition, the free silicone can move. The free silicone can migrate to the groin region and down the legs. I have had several patients who due to the excessive silicone associated scar tissue have problems with their electrolytes, specifically calcium. Also, I have had patients with excessive silicone buttock scar tissue develop kidney failure requiring kidney transplant. In addition, I have had several patients whose silicone butt scar tissue turns into granulomas, which then turned into cancer. I stress that these scenarios do not happen to every patient; however, I would urge you to have your buttock silicone removed as soon as possible before symptoms and progression of scar tissue develops. Thank you for your questions regarding what happens if you do not remove the silicone which previously been injected illegally into your buttocks. If you are considering silicone butt removal, please seek a specialist. Travel out of state if you must. Thank you for your question regarding the potential complications of not removing buttock silicone. Sincerely, Dr.Katzen. (certified by the American Board of Plastic Surgery).