Silicone in butt and hips is causing me mobility issues. Will I look disfigured after removing?

Thank you for sharing your story. This is a serious and unfortunately not uncommon situation. Given your symptoms and history, it's important to approach this comprehensively. Here's a breakdown of the key issues based on what you’ve described:

1. Depth and Spread of Silicone - Silicone tends to migrate, induce fibrosis, and adhere to or compress nerves/muscles, especially over time. Different injection techniques and needle lengths suggest variable depths and spread patterns, which can make complete removal challenging.

2. Your Symptoms - Muscle atrophy, gait disturbance, and poor balance are red flags and may indicate
chronic nerve compression or damage, Ischemia (reduced blood flow) due to fibrotic changes, disuse atrophy from pain or dysfunction. MRI imaging with and without contrast (silicone protocol) would help determine if silicone is compressing key nerves like the sciatic or gluteal nerves.

3. Complexity of Removal - Removal should involve staged surgeries and partial excisions from different tissue planes (fat, fascia, muscle) and ultimately a stage of reconstruction to replace volume that was lost during the initial silicone removal stages. Some silicone may be inaccessible or unsafe to remove if it's too close to vital structures (e.g., sciatic nerve).

Please note although volume loss and contour irregularities are common after removal, there are reconstructive options such a fat grafting to restore shape and function of the buttocks. A skilled surgeon can often minimize deformity. In most cases, patients see significant gains in mobility and reduction in pain within days to weeks after surgery.

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

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