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

Question

I’ve had multiple silicone injections over the last 10 years .By two different “providers” using different techniques & and different length needles. I believe the silicone is compressed on my muscles or nerves and is causing gait problems and muscle Atrophy in my legs. m Legs are keeping weaker and my balance is bad. I believe the silicone is injected deep into the muscle and also on top of of the muscle or in the fat . Does this make my situation or removal more complicated? Will I be disformed? & most important will I be able to regain my strength and balance after removing silicone from butt and hips

Jeremy S. Nikfarjam, MD · Answer

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

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding silicone in the buttocks and hips, causing you pain and mobility issues, and whether you will look disfigured after removing the injected silicone.  You must remove the silicone.  Silicone causes a whole host of inflammatory responses, autoimmune diseases, and can cause problems with disfiguring, scarring, and migration, even without surgery.  Silicone is not a naturally occurring product in the body.  Therefore, since the body is designed to react to anything that is not supposed to be in your body, the silicone causes an inflammatory response.  Inflammatory responses include swelling, pain, itching, scarring, and skin discoloration.  Injected silicone also causes the body to create antibodies, which can cross-react with other tissues in your body.  Silicone has been linked with a condition called ASIA syndrome. Silicone is not inert and does not just sit there; silicone causes your body to react.
Your workup should include an MRI of the injected areas.  The MRI will determine the location of the product.  The MRI will determine whether the silicone is superficial or deep in the muscle.  If the muscle is accessible, like the gluteus maximus muscle, superficial injections of silicone into its superficial fibers can be removed.  However, if the silicone is deep in the muscle, it may not be worth going after the silicone.  The fact that silicone is in your body makes surgery difficult.  The fact that silicone is in your muscle makes the surgery even more difficult.  Deformity is relative.  Removal of the injected silicone should be your top priority, not the appearance.  You must remove the silicone product.  After the removal of the silicone, soft tissue deformity often can be corrected with fat transfer or other soft tissue fillers.  However, it is much more important to remove the product first and consider the deformities left behind from silicone removal secondarily.  Almost all patients can regain their strength and balance after silicone removal from the hips and buttocks, even after the product is removed from the muscle.  Good luck.  Thank you for your question regarding silicone and the body and hips, causing mobility issues, and whether you will look disfigured after removing the injected silicone.
Since removing silicone is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in removing silicone.  Do your research.  Make sure they have performed many silicone 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 silicone removal surgeon in your neighborhood, consider traveling out of state if you must.
Sincerely, Dr. Katzen, MD, MBA ( Plastic Surgeon, President of the American Society of Bariatric 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, Director and chief clinical investigator at the Institute of Silicone Removal, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel, Director and Chief Investigator of Silicone Removal Institute.)

Jose Telich, MD · Answer

Hi Nice18501 — thank you for sharing your story. What you’re describing is, unfortunately, a known complication of silicone injections, especially when performed by unlicensed providers or with industrial-grade silicone. When silicone migrates or is injected deep into muscles or near nerves, it can cause inflammation, pain, weakness, or mobility issues like the ones you’re experiencing.

Removal can be complex, particularly when the silicone is both inside and above the muscle, but an experienced plastic surgeon can carefully plan your treatment. Depending on how widespread the silicone is, the approach may involve open excision, staged procedures or even require taking tissue from other parts of the body to cover the area that was resected.

In terms of appearance, it’s possible to experience contour irregularities after removal, but these can often be improved later with fat grafting or reconstructive surgery once the inflammation has resolved. Most importantly, removing the silicone can help prevent further tissue damage and improve function.

It’s crucial that you seek a board-certified plastic surgeon experienced in biopolymer or silicone removal as soon as possible for imaging and a full evaluation.

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

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

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