If I have no symptoms should I still remove silicone butt injections? (Photos)

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

Hi and thank you for your question!
The question of whether to remove asymptomatic silicone/biopolymer granulomas is one in which needs to first be fully explored and properly examined, and then determined to actually be asymptomatic. There are many patients who don’t express symptoms voluntarily but do report discomfort with prolonged sitting, the need to shift their buttock weight while sitting, difficulty performing exercise including squatting due to discomfort in the buttocks, as well as nighttime fevers, and other aches and pains which can be present with silicone disease. On examination, patients sometimes have nodularity, contraction and hardness of the buttock soft tissues with discoloration, and still report no symptoms. So if all of the above are not present, it becomes a decision only to be made by the patient. However, if the patient does have mild, moderate or severe symptoms, or even without symptoms, has skin thickening, nodularity or discoloration on buttock exam, these are valid reasons to pursue removal done in a staged, open approach.
As always, please make sure to only consult with board certified plastic surgeons who specialize in these procedures. I hope that this helps.

Thank you for whether you should get your silicone butt injections removed even though you do not have symptoms. In my opinion, I still would have your silicone butt injections removed even though you are not having symptoms. Over time scar tissue develops around the silicone butt injections. As the scar tissue increases, the buttock has a cosmetic deformity. Patients describe their butt as getting very large in several months. In addition, there is the threat of migration. I've had patients whose product migrates from the buttock to the ankle. Though rare, this emphasizes the point that products migrate from the buttock. Migration from the buttock has also been noted from the low back, mid back, hips, groin, and labia. Therefore a second reason to remove the product even before the symptoms develop is the chances of migration. A third reason to remove the product before symptoms develop is to avoid the complication of granulomas . Granulomas are scar tissue that forms in excess around a foreign body. Therefore even though you're not having symptoms, I suggest you have silicone removal to minimize the potential butt asymmetry, migration, and granulomas. I hope this helps to eliminate the fears regarding silicone removal.
I specialize in silicone buttock removal and subsequent buttock reconstruction. Since removing silicone from the buttock is an extensive 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.)

Totally up to you if you want silicone removal. Some patients have no symptoms initially, but silicone can tend to migrate over time (because it's a liquid), cause fatigue/pain, darkening of the skin, or infections. Generally, the earlier it is removed, the better the results (skin darkening is usually permanent).

Great question/s. Nicely posted photos. I will not discuss your foolish error in having illegal injections. It seems you are having symptoms of fatigue? There are 2 options to "try" to improve any present symptoms or future ones. OPTION 1: Excision as much of the injected products with normal buttock tissue and large superior buttock incisions. Expensive, deforming surgery. Need initial in hospital operation with many follow up surgeries to try to obtain a buttock. Fees from $25,000+++ Option 2: Lipo reduction of any sub cutaneous materials with pure fat grafting in sub cutaneous planes. In office surgery, less $$s, Not deforming. This is called BBL Reduction/Reshaping with ultrasound guided techniques. Fee $7,900+. Best to virtual consult with...