Will dents after silicone injection removal ever go away? Is BBL only option after or will exercise work? Is Sculptra an option?

Hi lonelystarcarlylesandro!

I'm really sorry you're feeling this way right now. What you're going through—physically and emotionally—is incredibly heavy, and it makes total sense to feel overwhelmed. This kind of surgery isn’t just physically taxing but emotionally exhausting too. You're not alone in this, even though it might feel like it. You're very early in your healing journey. At 5 days, swelling is still going down and tissues are adjusting—especially after an aggressive removal involving muscle. The dents you're seeing could be from: Fluid shifts and swelling resolving, loss of fat or muscle bulk from removal, temporary inflammation or tissue trauma. It can look worse before it looks better. That being said, if you’re noticing it getting flatter each day, it might be a combo of swelling going down and tissue loss. Optimal healing occurs anywhere from 6 months to a year post surgery so the above is to be expected during this time period. A reconstructive BBL isn't your only option but possibly your most comprehensive one depending on how much volume and contour correction you need.

1. BBL or fat grafting – is the best option if you want volume restoration with natural tissue. Can also help smooth out dents and asymmetries.

2. Sculptra or Radiesse – for small dents or gradual improvement; temporary, requires multiple sessions, not ideal for larger areas. Keep in mind, this option could potentially cost more than a surgical procedure if used in larger quantities.

3. Exercise – can help if muscle was preserved in some areas. Muscle-building (especially glutes, quads, hamstrings) may slightly improve contour over time, but it likely won’t replace what was removed.

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 and a third stage of reconstruction (often referred to as a reconstructive BBL). This approach is designed to ensure the most complete removal possible while minimizing risks and optimizing patient outcomes. I'd be happy to see you for a clinical evaluation whether it be a complimentary virtual consultation or an in-office appointment to discuss your options. My Silicone Coordinator has undergone silicone removal and reconstruction and would be happy to get the ball rolling to see how we can help. (516) 279-2616

Hello Lonely Star Carly Sandro in Aspen,

Thank you for your question regarding the reconstruction options following silicone injection removal. You've undergone a significant procedure, and it's understandable to seek ways to restore contour and aesthetics to your body. I'd first like to say that your results looks great. You are likely being harder on yourself knowing what your buttocks previously looked like. It's easy to compare your pre-operative buttock to your current and notice the differences. However, others won't judge as harshly as you will. Now onto my suggestions:

Exercise: Exercise can indeed help to some extent by building muscle mass in the gluteal region through specific workouts like squats, stairmaster routines, and hip thrusts. Engaging a personal trainer could optimize your results by tailoring exercises to target your needs effectively.

EMsculpt: This technology utilizes electromagnetic energy to induce muscle contractions and can help build muscle in the buttocks, enhancing shape and volume.

Brazilian Butt Lift (BBL): BBL remains the gold standard for buttock enhancement after issues like yours. It involves transferring fat from other areas of your body to your buttocks. This method is generally preferred after a healing period post-silicone removal, typically at least four months, to ensure safety and effectiveness.

Sculptra: While a viable option, Sculptra is costly and may require multiple treatments. It's a synthetic filler that stimulates collagen production, providing a temporary solution compared to the permanence of a BBL.

Buttock Implants: Another alternative is the use of FDA-approved buttock implants, which are designed specifically for the area and provide a permanent solution without the risk of migration like free silicone.

Given your recent surgery and the aggressive nature of your previous silicone injections, it is crucial to allow your body sufficient time to heal before undertaking further procedures. Starting with exercise is a practical approach, and if, after a year, you find the results unsatisfactory, you can consider more invasive options like BBL, Sculptra injections, or implants.

I hope this response helps clarify your options and provides a path forward as you recover from your surgery. Best wishes on your journey to recovery and body confidence.

Sincerely,

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