What is the best way to remove silicone injections in buttocks?

Hello, thank you for your question regarding removing silicone previously injected into the buttock.  There are two methods to remove silicone from the buttocks: liposuction and direct excision.  Your plastic surgeon is partially correct in that silicone cannot be removed with traditional liposuction, BUT using intra-operative ultrasound, VASER-assisted liposuction, and a custom liposuction cannula, silicone and associated scar tissue can be removed from the buttock.  I use buttock liposuction for mild to moderate cases of silicone butt.  Buttock liposuction works well for patient with several small to moderate masses of buttock scar tissue.  Alternatively, if your case is more severe with several hard silicone nodules and/or hard buttock scar tissue, you need an incision with direct silicone butt excision.  The incision for silicone buttock skin, silicone, and scar removal can be placed horizontally on top of the buttock (like a seagull's wings), under the buttock, or vertically in the buttock crease.  The placement of the incision and thus, the resulting scar depends on the location of the underlying silicone and scar tissue.    I hope that I have answered your questions removing silicone from the buttock. 

Before you make any decisions regarding silicone 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 silicone removal  expert. If you have any more questions regarding silicone 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.)

Hi Newmeofsil,
I understand that the search for treatment for this unique condition is difficult! This is not something that is widely understood in the medical community. And it's not something one learns in medical school. I'd emphasize that treatment from a board certified plastic surgeon with experience with this specialized procedure is critical.I have treated hundreds of patients to remove silicone from the buttocks- some as revisionary procedures from previous removal attempts. The open technique is the only way to remove this product. I have some videos on my Instagram that illustrate this. The silicone granulomas and accompanying scar tissue pieces are far to big to fit through the liposuction cannula. I have treated patients who have attempted liposuction removal prior to seeing me who have reported the liposuction actually worsened their condition.
I wish you all the best in your search for treatment!
- Dr. NIk

Silicone biopolymers are being used throughout the world for facial and body volume augmentation. Results are longer-lasting that Juvederm or Restylane. 
Bellafill and Artefill are known to cause granulomas and permanent nodules with swelling. This is not the case for everyone. Silicone biopolymers can also cause similar chronic inflammatory conditions. 
In my practice, I specialize in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. 
Silicone biopolymers can also be removed from the body if there are signs of migration or inflammation. All of these filler-types should be removed as early as possible. 
Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon