Will a surgeon perform silicone removal of the buttock and reconstruction at the same time?

Unfortunately, I am having to do more and more of these procedures.  The material is removed in the first stage.   A period of 3 months or so is observed.  A BBL can be performed later to improve the appearance.  The two stage procedure can be done for slightly less than $20,000.I perform about 500 Brazilian buttlifts each year, and this
procedure is the most surgeon dependent plastic surgery procedure. Find
a plastic surgeon with ELITE credentials who performs hundreds of
Brazilian buttlifts each year. Then look at the plastic surgeon's
website before and after photo galleries to get a sense of who can
deliver the results. Kenneth Hughes, MDLos Angeles, CA

To answer your question, technically, yes. Fat can be grafted on top of the silicone. However, it is not recommended as there is a risk the fat may not integrate well because the gel creates a foreign body environment. The gel may impede vascularization, reducing fat graft survival. Injecting fat may disturb the hydrogel, potentially triggering migration or inflammation. So, while it’s possible, it’s not considered the safest or most effective approach in many cases. Removing any foreign body material is always recommended first. Ideally. removal would be the safest path forward before fat transfer. This ensures as much foreign material is removed as possible, reducing the risk of adverse reactions. It allows for a more biologically “clean” plane for fat graft survival. It enables better long-term aesthetic results and reduces unpredictability. A consultation with a Board-Certified surgeon experienced in silicone removal is crucial. Typically, the surgical steps are as follows - Stage 1: Removal of silicone via open excision approach. Stage 2: performed typically within 24-48 hours after stage 1. This includes a secondary removal after wound vac placement and an internal buttock lift. After a 3-month recovery/healing process, we can perform Stage 3: Fat grafting once inflammation has resolved and tissue planes are healthy. Please keep in mind, these procedures can be covered by insurance. 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 share her silicone journey with you and see how we can help with yours. (516) 279-2616

Hi and thank you for your question regarding if silicone removal of the buttocks and reconstruction can be performed at the same time. Also, regarding costs, each patient is different. Most plastic surgeons do not give out quotes without a consultation.

Reconstruction (BBL or fat transfer) should NOT be done at the same time as the removal. This will lead to high risk of infection and death of the newly transplanted fat. I hope that I have answered your questions regarding removing silicone from the buttock The FDA warns AGAINST silicone injections on their website. The FDA states “Do not get injectable silicone or any type of filler material for large-scale body contouring or enhancement.” Also, the FDA has said “Injectable silicone is permanent, with side effects that can occur right after the injection and up to years after treatment. Silicone spreads and migrates easily inside the body, which may worsen adverse events and make surgical attempts to remove the silicone oil more difficult or impossible. Silicone, when injected into areas with many blood vessels such as the buttocks, can travel to other parts of the body and block blood vessels in the lungs, heart, or brain. This can result in permanent damage to those tissues and lead to stroke or death.” Since removing silicone from the buttock is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone from the buttock. Do your research. Make sure they have performed at least 100 buttock 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, buttock silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic 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 and RealSelf Hall of Fame.)

Our office is the leading center for the removal of foreign body fillers in the United States. My approach is protocol based, beginning with an examination to determine the grade of inflammation using the Karamanoukian Grading Scale for Soft Tissue Inflammation. Silicone biopolymers and PMMA can be safely removed from the face and body. Longterm complications are minimized with diligent attention to detail and protocol-based treatment. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

It is essentially impossible to remove all of liquid silicone from any body part.  Although you may eventually have complications, you may consider leaving it in place for now unless you are currently experiencing problems.  I recommend consulting with a board certified plastic surgeon specialist in buttock augmentation surgery sooner than later.  Glad to help,

Silicone injections to any where in the body is not a good idea. We will never know what exactly was injected. silicone can come in different types, it is a commercial grade silicone. It causes significant amount of inflammatory reaction, and forms granulomas, silicone oil cysts. When injected it disperses through out the buttocks. If there are hard areas, or areas of intense reaction then those areas can be taken out. One can not take out all the silicone that was injected. In my experience one can remove about 50-60% of the material but that will leave the buttocks with a deformity. Correction of the deformity can be done 3-6 months after all is healed. Since the silicone injected is not a medical grade silicone, it is laden with bacteria and every time you do surgery you run the risk of infection and recurrence of the granulomas. I have seen it injected deep into the muscle which makes that portion impossible to remove. The surgery is really a debulking procedure. Samir Shureih MD.FACSsshureih@msn.com

It can not be removed. It usually goes through out the tissue and can not be removed. The injection of silicone is illegal in this country and should not be done. Once you get it, you will be plagued by it. There is no good cure. Steroids can help with the inflammation, but if it gets infected, it is a big mess.