Looking for a doctor that does silicone removal. Does my ct scan look bad? (Photo)

Question

I had an ct scan done on 4/18 an this is was it shows, it is causing me a lot of pain ! It isn’t hard or hot it’s soft but the pain is becoming alot ! I am looking for doctors to have it removed asap the pain is starting to go down my legs! Please help

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding silicone injections into the buttocks. In regards to your CT scan, the CT scan shows silicone injections. I have seen worse cases and I have seen cases with less silicone. Either way, I would highly suggest that you have the silicone removed as soon as possible. It is only a matter of time before a product migrates and causes more symptoms. Due to the permanent nature of silicone, it will not go away naturally. Nothing will dissolve it like hyaluronidase or steroids. Nothing well minimize your reaction to it like steroids or antibiotics. Unfortunately, you have to get this surgically removed. Please seek an experienced board-certified plastic surgeon who has removed Silicone from hundreds of patients. Good luck.

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.)

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.)

Carlos Alberto Ríos García, MD · Answer

I understand your concern. The fact that the pain is progressing into your legs and affecting your ability to function normally is something that deserves careful medical evaluation and should not be minimized.
Based on the CT images alone, it is not possible to safely determine how severe the situation is or whether surgery is immediately necessary. However, imaging in silicone and biopolymer cases is mainly important because it helps identify:
* how diffuse the material is* depth of tissue infiltration* migration patterns* involvement of fascia or muscle* inflammatory changes* and proximity to important nerves and structures
One important thing to understand is that severe pain can occur even when the tissue externally does not appear very inflamed, hard, or hot. Chronic inflammation, fibrosis, pressure on nerves, lymphatic compromise, and tissue infiltration can all contribute to symptoms like:
* pain radiating down the legs* numbness* burning sensations* sitting intolerance* weakness* or mobility limitations
At the same time, removal surgery in cases like this can become highly reconstructive and technically complex. Silicone often becomes diffusely integrated into fat, fascia, scar tissue, lymphatic structures, and surrounding soft tissues, which is why treatment planning requires balancing:
* symptom improvement* preservation of healthy tissue* nerve protection* circulation* lymphatic drainage* and long-term contour stability
Without full imaging review, physical examination, and symptom correlation, it is impossible to determine which areas may realistically benefit from intervention versus which areas may carry higher surgical risk.
Cases involving progressive pain and migration are usually best evaluated by surgeons experienced specifically in silicone and biopolymer complications, because these situations are often far more complex than standard cosmetic revision surgery.

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 there and thank you for your question. 
Unfortunately it is difficult to properly evaluate CT images through photographs but it is fantastic that you have already taken the first step in working up your case. Silicone/biopolymer foreign body removal surgery is becoming a very common and, in my opinion, medically necessary surgery that not every surgeon truly understands or is comfortable performing. I would encourage you to schedule an in-person or virtual consultation with board certified plastic surgeons, board certified by the American Board of Plastic Surgery (ABPS), who specialize in these highly complex removal procedures. 
In my private plastic surgery practice I perform many silicone/biopolymer foreign body removal procedures each month on patients who have had this material injected to the buttocks, breasts, thighs, hips, face and lips. These procedures are each performed using an excision technique to effectively remove as much of the free-silicone/biopolymer material and associated granulomatous and scar tissue in the hopes of relieving some, if not all, of the patients often debilitating symptoms.  While removal is never 100% guaranteed as the material is not encapsulated within an implant shell, the goal is to remove as much as possible within safe limits to help restore normal function and health to the patient in need. Being that you are already prepared with a CT scan (and hopefully the images on a CD as well) you are already one step ahead of the game, as imaging is an important part of the pre-surgical workup! Please consider scheduling an in-person or virtual consultation with a board certified plastic surgeon who specializes in these procedures to discuss your next steps, expectations and most appropriate surgical plan. Please also keep in mind that many times silicone/biopolymer foreign body removal surgery can be covered by your insurance! 
I wish you all the best and I hope that this answer has been helpful to you.

Praful Ramineni, MD · Answer

Silicone removal with lipoaspiration through a tiny incision in the buttock crease can often alleviate/eliminate symptoms of pain, fatigue, hardness, etc.  Your imaging looks fairly standard for injections.

Looking for a doctor that does silicone removal. Does my ct scan look bad? (Photo)

Answers (5)

More Silicone Injection Removal Questions

Is there any insurance that covers Biopolymer injection removal?

Is it possible that face biopolymers don't show up on an MRI?

What can be done to remove the silicone from my upper lip? (Photo)

What are my options for liquid silicone removal from my nose?

Had buttock injections 2 years ago by a lady that's certified for fillers/threads. Pregnant and concerned it will affect me?

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

WE SEND PRETTY
EMAILS