Why would silicone injections not show on an MRI or CT scan?

Question

Please I need help, I recently got a Ct Scan and MRI at E.R & dosnt show any silicone injection but Im experiencing so much pain & burning on my legs & buttocks. I consulted with a out of sea doctor & he confirmed i have silicone migrating to my hips & stuck to the muscle & they were able to tell with the MRI. I just need a second opinion because i dont understand why the substance dont show or doctors cant tell here in the U.S

J. Timothy Katzen, MD, FACS · Answer

Hello Anonymous2027 in Bronx, NY, 
Thank you for your question regarding why would silicone injections not show on an MRI or CT scan
Sometimes radiologist are not accustomed or familiar with seeing silicone injections in the buttock. Many doctors don’t even know about the phenomenon of illegal butt shots. Therefore, the silicone may be present on the MRI and CT images however, the physicians examining the images may not have been able to recognize the dots as silicone.  The situation doesn’t have to do with the MRI or CT scan not showing the silicone. It has to do with the interpretation of the pictures obtained by the MRI.  Therefore, it is wise for you to go to a silicone specialist who can order the MRI and review the images with you. Not all doctors are adept with seeing silicone on MRI or CT scans. As a side note, a MRI is better than a CT scan for silicone because a MRI can see deeper into the tissues.  Good Luck.  I hope that I have answered your question regarding why would silicone injections not show on an MRI or CT scan.  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.)

Raffy Karamanoukian, MD, FACS · Answer

The sensitivity of ultrasound for imaging silicone polymers is high and that is my preferred in-office diagnostic tool for silicone disease. In Los Angeles, I usually begin a consultation for silicone disease with a careful examination followed by ultrasound to biometrically locate silicone deposits in the soft tissue and around the muscle. In a recent clinical research study that I performed, we used ultrasound to locate migrating silicone in the lymph nodes and non-contiguous areas.

I would schedule an appointment so that we can source your silicone disease and find options for removal in Los Angeles.

I would schedule an appointment so that we can source your silicone disease and find options for removal in Los Angeles.

Carlos Alberto Ríos García, MD · Answer

I understand your confusion&mdash;and your question is very valid.
The most important thing to know is this:**silicone itself does not always appear clearly on standard MRI or CT scans.**
What most radiologists see is not the silicone directly, but the **reaction your body creates around it**, such as:
* scar tissue (granulation tissue)* inflammation* changes in fat and muscle planes
That’s why reports often describe things like *“low signal areas”* or *tissue irregularities*, instead of clearly saying “silicone.”
Now, here is where the difference really happens:
Not all MRIs are done the same way.
There are **specific MRI sequences designed to better identify injected substances and track migration**, showing:
* where the material has spread* which tissues are involved* and how deep it is (fat vs muscle vs deeper planes)
If those sequences are not performed&mdash;or if the radiologist is not experienced in this type of case&mdash;the study can be read as “normal” or inconclusive.
Your symptoms matter a lot here.
Burning, pain in the legs, hips, or buttocks&mdash;these are very commonly associated with:
* migration of injected material* chronic inflammatory reaction* or nerve irritation from the surrounding fibrosis
So even if the scan report says “nothing is seen,” it does **not rule out the presence of silicone**.
In my experience (over 20 years treating these patients), this situation is very common:patients are told everything is normal, but clinically, the problem is clearly there.
The key is:proper imaging protocolcorrect interpretationand correlating that with your symptoms
If you’d like, I can review your MRI and explain exactly what is happening and whether the correct sequences were used, so you can finally have clarity on your case.
You’re not imagining this&mdash;and there is an explanation for what you’re feeling.

Jeremy S. Nikfarjam, MD · Answer

Hi!  At our practice, we send patients for MRI as part of our silicone removal workup.  The imaging reports often don't visualize silicone, per se, but what they will reveal are the changes to the skin, tissue, and muscle which will often be characterized as "low lobular regions of low signal" and/ or "granulation tissue."  And these are the silicone encapsulated in scar tissue which is what is likely causing you pain.  Please feel free to contact our office and we can take a look at your report or send you for a new one.  We work with insurance and perform several hundred of these cases per year.

Darryl J. Blinski, MD · Answer

I recommend you, personally, obtain a copy of the scan and or MRI. Then you can send it to be reviewed elsewhere. Sometimes the radiologist is not familiar with illegal injected buttocks .. 
otherwise only virtual consult can offer you additional answers.

Why would silicone injections not show on an MRI or CT scan?

Answers (5)

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