Migration of silicone injection to whole body (Photo)

Question

Hi I’ve foolishly had silicone injections injected into my breasts and buttock in Jan this year and I started experiencing complications. Had a removal overseas in August this year through needle aspiration and negative pressure suction and the silicone had spread extensively to my back, arm, thighs, stomach, calves. Basically everywhere. I’ve been getting joint pains, nerve pain everyday and I am living in fear. I’m loss and very devastated I want this out of me can any doctors help? Thank you!

Jeremy S. Nikfarjam, MD · Answer

Hi Vivid264411!

First of all, I’m so sorry you’re going through this. What you’re describing is very real and incredibly difficult, both physically and emotionally. You are not alone. You’ve already taken a brave step by trying to have the silicone removed, but unfortunately, needle aspiration and negative pressure suction often don’t work well for this type of issue — especially once silicone has migrated. It sounds like the material has traveled beyond the original injection sites, which is common with unencapsulated free silicone, and that your body is reacting to it systemically (inflammation, pain, etc.). The joint pain, nerve symptoms, and general inflammation you’re experiencing are consistent with systemic inflammatory response to silicone. Some people develop silicone-induced granulomas, chronic inflammation and autoimmune-like symptoms.

I recommend consulting with a board-certified plastic surgeon who specializes in silicone/biopolymer removal via surgical excision. The first step would be to start with MRI with and without contrast (silicone protocol). This helps identify where the material is and how deep it is. Depending on that factor, they will create the appropriate surgical plan to target and remove the remaining material. It's important to understand that 100% removal isn't possible (as it is not encapsulated like a breast implant is). However, substantial improvement, better quality of life and symptom relief can be achieved.

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. 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 as well. She can share her silicone removal journey and help guide you along the way with yours.  (516) 279-2616

Don’t give up! You are not hopeless. Many people have been in your shoes and have found relief after proper surgery. We look forward to speaking with you.

J. Timothy Katzen, MD, FACS · Answer

Hello Vivid264411 in Melbourne,

Thank you for your question regarding the widespread migration of silicone injections. This is indeed a complex and challenging situation, and I appreciate your trust in seeking guidance.

Given the extensive spread of silicone as described, it is imperative to prioritize areas where the silicone poses the most immediate risks to health, typically the breast and buttocks. The first step in your journey should be obtaining detailed imaging, specifically an MRI with and without contrast, to ascertain the precise locations and volume of silicone present.

For surgical intervention, starting with the buttocks is advisable due to the potential for larger volumes of silicone and its proximity to significant anatomical structures. Depending on the MRI findings, silicone removal can be performed either by suction—often referred to as ultrasound-guided VASER-assisted silicone suction—or via a more invasive open technique. The latter is generally required if silicone has infiltrated muscle tissue.

Following the buttock procedure, attention should shift to the breasts. This involves making an incision under the breast to remove silicone and any scar tissue. Depending on the severity of tissue involvement and patient wishes, this step might also include immediate or delayed breast reconstruction using implants.

Addressing migrated silicone in other body parts, such as the arms, legs, and back, should ideally occur in a separate surgical session to minimize recovery complications and maximize procedural focus and safety.

Throughout this process, choosing a board-certified plastic surgeon with experience in managing complications from silicone injections is crucial. Such a surgeon can provide a tailored approach that addresses both aesthetic concerns and health risks.

Thank you for sharing your concerns, and I wish you the best on your path to recovery. Please feel free to reach out with any more questions or for further clarification.

Sincerely,

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

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

Migration of silicone injection to whole body (Photo)

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Migration of silicone injection to whole body (Photo)

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