I had biogel injections done about 5 years ago. I live in NYC and seeking help removing them in the NYC area. (Photo)

Question

What does the areas that are discolored on my buttocks? Could it be An infections ? Or inflammation? What should I do ?

Emmanuel De La Cruz, MD · Answer

Unfortunately there's not a lot of procedures in the removal of biopolymer or biogel buttock injections.  Biopolymer injections may cause chronic infections, chronic pain and discoloration of the skin.  This is a difficult problem to have due to the potential complications that may result from previous injections.  If you're symptomatic then I would recommend having them removed.  You'll likely need an MRI of your buttock to delineate the location and extent of the silicone granulomas of the buttock.  The MRI would serve as a map so that your plastic surgeon would know where to remove them.  Biopolymer injections from the buttock may be removed either by direct excision versus VASER liposuction.  I would recommend VASER liposuction for removal of the biopolymer followed by fat transfer.  Good luck and may God bless you.
Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Jeremy S. Nikfarjam, MD · Answer

Thanks for sharing your story. I'm really sorry you're dealing with this. Based on what you're describing, it sounds like you're having a late-onset reaction to whatever was injected, which could be biogel (often referred to as silicone) or possibly something else entirely, since unregulated injections often involve mixed or misrepresented substances. If you're experiencing purple discoloration, here are a few potential reasons: chronic inflammation or granuloma formation beneath the skin, causing vascular changes and pigmentation; slow tissue breakdown (common in long-term filler complications); post-inflammatory hyperpigmentation - if there was a previous flare-up, infection, or irritation. The good news is - in many cases, this is fixable, but it depends on what’s going on underneath the surface. An MRI with and without contrast must be ordered to help identify if there is in fact silicone present in those specific areas and to see how it's behaving (migrating, inflamed, etc.). If the biogel is causing inflammation or granulomas, you will most likely need surgical intervention. I have seen thousands of patients who have been victimized by illegal silicone injections. The symptoms I see range from mild to moderate to severe- requiring emergent hospital admissions. What you report is a familiar story that we here in the office- hyperpigmentation accompanied with pain in the buttocks, back, and legs. Sometimes this pain is accompanied by intermittent tingling in the extremities. Treatment is possible! After training in hospitals in The Bronx in the early '00s, I saw countless patients present to the emergency room with symptoms related to silicone disease but were not given any substantial treatment. They were given antibiotics and pain medications and sent home. It was then that I decided to pioneer the silicone removal center in New York. You can read more through the link below. Ultimately, I perform a two-stage open removal procedure (through a small incision inside the buttocks crease) with a third stage reconstructive BBL. All three stages are pre-authorized through a patient's health insurance. I only perform these procedures in a hospital setting with a dedicated team that I have handpicked to assist in these unique procedures. I believe this is a medical problem that needs real, medical treatment (in the U.S., in a hospital, with a board-certified plastic surgeon). Of course, the aesthetic component is very important, and as a plastic surgeon, I do everything I can to make sure my patients not only feel great but look great afterwards as well. Please feel free to contact my team to inquire about your particular insurance policy. 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 share her silicone journey with you and see how we can help with yours.  (516) 279-2616

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question regarding discolored areas on your buttock after biopolymer injections. Basically, biogel is a foreign body. Your body is reacting to this foreign body and creating scar tissue. This is an inflammatory response. During the inflammatory inflammatory response, the skin changes color. Additionally, your body is trying to reject the biogel. Your body is trying to reject the biogel by creating a path from the biogel to the skin (sort of like a volcano). However, the bio gel is caught in so much scar tissue, that your body cannot eject the biogel. Therefore, there is a constant cycle of your body trying to create scar tissue around the biogel, rejecting the bio gel, and the skin trying to make a path to expel the biogel. In addition, there is usually localized infection. The best thing to do is to have the biogel injections and the associated scar tissue removed. If the masses are small and soft, the biogel and its associated scar tissue can be removed with intra-operative, ultra-sound guided, VASER assisted liposuction.  If the masses far more extensive, you may need an incision either on top of or under the bottom of the buttock.I hope that I have answered your questions removing biogel from the buttock.  
  
Before you make any decisions regarding biogel removal from the buttock, I would suggest you seek consultation with an expert. Please seek an experienced, board-certified, plastic surgeon.  Travel out of state if you must to find such a biogel removal  expert. If you have any more questions regarding biogel removal from the buttock, intra-operative ultra-sound guided VASER assisted liposuction or plastic surgery in general, please contact my office.  Sincerely, Dr. Katzen. (Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, American Academy of Cosmetic Surgery, and Fellow of American College of Surgeons and American Board for Metabolic and Bariatric Surgery, Awardee: RealSelf 100.)

Carlos Alberto Ríos García, MD · Answer

Regards, Dr Carlos Alberto Rios regrets that you have been victim of the terrible practice of biopolymers.

For your information, in 1898 Dr. Robert Gersuny, Austrian surgeon, injected paraffin into the scrotum of a patient who was orquiectomizado (testicles removed). Here began the history of the injection of external substances to give volume to the face and body. This practice became very popular and now, there are whole chapters in plastic surgery books that explain how to try to correct and rebuild the serious effects of the application of paraffin.

The Biogel is also a biopolymer, but specific photos are needed for a more accurate diagnosis. I must know what are your manifestations of the A.S.I.A. Syndrome (Autoimmune inflamatory Syndrome Induced by Adjuvants that causes generalized systemic bodily manifestations of inflammation) to a better assess of the state of the disease and thus be able to help. About what you have in your skin they are scars, it may be from the place where the substance was injected, but they are scars.

Please remember to be aware, do not let any permanenrt filler to be injected into your face, breast, buttocks, calfs, genitalia, etc. The safest way to increase buttocks is through your own fat injections or through silicone implants.

I hope the information was usefull, have a nice day! Dr Carlos Rios.

Raffy Karamanoukian, MD, FACS · Answer

Silicone reaction is very diverse and covers a spectrum of inflammatory manifestations. I would suggest surgical removal of the silicone as early as possible. Best, Dr. KaramanoukianLos Angeles

I had biogel injections done about 5 years ago. I live in NYC and seeking help removing them in the NYC area. (Photo)

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