I received illegal butt injections about 10 years ago. I've never encountered any complications, but I want it out (Photo)

Question

It's deflated and looks horrible, some dark spots, knots and dents in my butt... can this just be suctioned out or will I need to be cut

Carlos Alberto Ríos García, MD · Answer

I understand your concern. Many patients begin considering removal years later when they start noticing contour irregularities, firmness, discoloration, dents, tissue changes, or progressive deformity even without major systemic symptoms.
Based on the photos and your description, this does not appear to be a simple cosmetic volume issue alone. Long-standing injected materials can sometimes create chronic inflammation, fibrosis, scar tissue formation, tissue atrophy, migration, and damage to the normal fat layers over time, which may explain the irregular texture, nodules, and deflation you are noticing.
Unfortunately, injected silicone usually cannot simply be “suctioned out” like regular fat in many cases. Once the material infiltrates the tissues diffusely, it often becomes intertwined with scar tissue, lymphatic structures, and normal fat planes. Because of this, some patients require open surgical removal, while others may require a combination of techniques depending on how localized or diffuse the material is.
Without imaging studies and a physical examination, it is not possible to determine how extensive the infiltration is or which surgical approach would be safest in your specific case.
One of the most important aspects in cases like these is balancing removal of problematic material with preservation of tissue viability and long-term contour, since aggressive removal can sometimes create additional deformity if not planned very carefully.

Jeremy S. Nikfarjam, MD · Answer

Hi Emparise89!

This is a great question! Illegal butt injections often involve substances like silicone, hydrogel, or biopolymers that are not meant to be in the body. These substances can migrate, harden, or cause chronic inflammation over time. Unfortunately, these materials cannot simply be suctioned out with liposuction because they tend to integrate with surrounding tissues. Instead, surgical removal— involving excision of the affected areas—are necessary. This process can be complex and may require a reconstructive approach to restore the shape of your buttocks. Here at my silicone removal center located in New York, 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 which is performed in a hospital setting. This approach is designed to ensure the most removal of silicone/biopolymer as possible, while minimizing risks and optimizing patient outcomes. I specialize not only in the removal phase, but the reconstruction phase as well. Please keep in mind, silicone removal along with reconstruction can be covered by insurance. To schedule a complimentary virtual or in-office appointment, please call (516) 279-2616. My Silicone Coordinator (who is also a silicone removal patient) will initiate the process by gathering a basic health history, discussing your silicone injection history, sending you for appropriate imaging (such as an MRI with and without contrast) and will assist in scheduling your complimentary consult.

I wish you all the best! We’re happy to help if you need us.

Best,
Jeremy Nikfarjam, MD PC
Board-Certified Plastic & Reconstructive 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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding illegal silicone buttock injections and what to do about it. Even though you're not experiencing complications, you should have the silicone removed. Reaction to the silicone only worsens over time. Scar tissue continues to grow and causes deformities, as you've been experiencing. Additionally, the skin can become indented with dimples as the scarring continues. The skin can also start to stain. Furthermore, silicone from the body can spread. There are cases where the silicone has spread from the buttocks to the ankles. To determine the extent of the issue, you need a thorough evaluation. This should include an MRI of the pelvis without contrast. Once the MRI is completed, it can determine how much product you have, how much scar tissue you have, and the position of the illegal product. The position helps determine whether it's in the fat, the gluteus maximus muscle, or both. MRI results will guide the treatment plan. Based on your pictures, it looks like you would do best with the open or cut technique. I hope this helps answer your question about what to do regarding illegal buttock silicone injections. Good luck.

Sincerely,

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

Sincerely,

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

Daniel P. Markmann, MD · Answer

Unfortunately, there is no way to remove it all without removing your entire buttocks.   I assume this was silicone?  That is what is most commonly used, but often other things are added or used in place of silicone.  It is illegal because it is unregulated, many things used are untested, and those that are tested are very dangerous with many complications, including death!   Most of these things that are injected are distributed or migrate throughout the entire buttocks.   The often cause your body to react to these foreign substances causing hard and painful lumps.  As I said, there is no way to remove all of this material without removing all the soft tissue of your buttocks!  But, we can remove the lumps.  Unfortunately, this will leave scars and often dents from where the lumps were removed.   Be sure you contact a Board Certified Plastic Surgeon with experience with this situation.  
Good Luck

Darryl J. Blinski, MD · Answer

Sorry for your poor decision using an illegal product to be injected into your body. But that’s the past. We have to address the future. Always best to virtual consult or in consult with. I offer three options. Option one large bore Lipo suction cannula removal. This can decrease the amount of injected tissue to an extent, and at the same time to liposuction in normal areas and reshape the buttocks. Fast recovery less downtime but cannot guarantee amounts removed. Option two is in hospital large incision of upper or lower buttocks or both surgical removal of the complete injected tissue above the muscle. Expensive over $25,000. Long recovery over six weeks. Deforming surgery will need multiple reconstruction surgeries. But this gives the best chance of exercising and removing all the damage tissue.  Option three combination of one and two doing an upper large incision inferior large incision removing materials in just those areas and then Lipo, reducing the central portion of the buttocks followed by fat crafting from Lipo and other areas can be an ambulatory center or hospital may need more than one stage . That is why an in person or virtual consultation is required for a understanding of options available in the process that will be done. There are very few boarded plastic surgeons in USA offering these options. Be sure you only go to a American Board of Plastic surgery , certified Surgeon. Regards.

I received illegal butt injections about 10 years ago. I've never encountered any complications, but I want it out (Photo)

Answers (6)

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