Can I get 10 year old biopolymer removal from my butt?

Question

31 year old vegan female no kids 125lbs at 5’6 with less then 20% BMI. Butt injections 10 years ago. Left cheek lanced leaving an 2cm indentation. Discoloration and pain.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your questions regarding whether you can get 10 year old Biopolymer injections removed from your buttock.The quick answer is “yes”. Since you were having symptoms with discoloration and buttock pain, I would suggest you have the product removed as much and as soon as possible. I would suggest pre-operative work up to include an MRI to determine the location of the product and whether the product is in the fat and /or gluteus muscle.  I hope that I have answered your questions regarding removing biopolymer from the buttock.  The FDA warns AGAINST silicone or biopolymer 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 specialize in biopolymer buttock removal and subsequent buttock reconstruction.  I am the Director and chief clinical investigator at the Silicone Removal Institute in Los Angeles, CA.   Since removing silicone and biopolymer from the buttock is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone or biopolymer from the buttock.  Do your research.  Make sure they have performed at least 100 buttock silicone and biopolymer 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 or biopolymer removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic 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.)

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

Jeremy S. Nikfarjam, MD · Answer

Hi and thank you for your question! I'm so sorry to hear that you're experiencing pain and discoloration. There is help though! First and foremost, it is very important to consult only with board certified plastic surgeons who specialize in silicone disease and these highly complex removal procedures. In my private plastic surgery practice, I've treated many patients who've had this material injected to the buttocks, thighs, hips, breasts, lips, and face. A large percentage of my patients have had their injections 10+ years. These procedures are each performed using a staged excision technique to effectively remove as much of the free-silicone/biopolymer material and associated granulomas and scar tissue in the hopes of relieving some, if not all of the patient’s symptoms.Hope this helps!

Kenneth Hughes, MD · Answer

In addition to complications such as infection, skin death, fat death (fat necrosis), inflammation, and pain in the areas injected, these injections can and have led to many patient deaths. When I see patients in my Los Angeles surgery center for evaluation, I always explain the multitude of complications that may occur in the removal of these silicone and biopolymer substances including fluid collections, infection, inadequate removal, fat death, skin death, tissue deformities, and tissue defects.

Praful Ramineni, MD · Answer

You are not too late to have the silicone removed, however some of the skin darkening is likely permanent.  The depressed scar could also be revised at the same time. Pain generally gets better after debulking/removal.