Purple butt after butt injections. What is it? Is it fixable?

Hello, thank you for your questions regarding PMMA injections into your buttocks.  Unfortunately, PMMA, hydrogel, silicone and many other countless products are still being injected illegally every day around the world.  Like you, most patients do not know even what has been injected.  In my 20 year experience as a board certified plastic surgeon, I have seen many strange things injected like cement, tire sealant, crazy glue, and even caulking materials. THE PROBLEM: The problem is a foreign body was injected.  In your case, this was may have been PMMA.  Your body views this PMMA as a foreign body and makes scar tissue around it in an attempt to wall it off (much like an embedded splinter of wood).  Once the PMMA or silicone is contained, your body is content for a while.  However, over time your body tries to push this material from your body.  Your skin rushes blood to the area to assist in expelling the PMMA or foreign body.  This is evidenced by the red or purple circles on your butt.  Sometimes the blood spills out from your capillaries and can permanently stain your skin. This blood spilling from the capillaries is called hemosiderin. Unfortunately, your body cannot expel the PMMA, and the internal scarring and subsequent skin staining just get worse.  To make matters worse, the excessive scar tissue can make granulomas, which over time can turn into cancer.    THE SOLUTION: You can treat the skin all you want, but the purple will remain unless you remove the causes or source.  In this case, the source is the PMMA.  I do not believe micro-needling will help because micro-needling will not remove the source problem, namely the PMMA.  In my experience, there are only two solutions to remove the PMMA or silicone from your buttock. If you have a mild amount of buttock scar tissue, I would suggest intra-operative, ultra-sound guided, VASER-assisted, Power Assisted Liposuction.  During ultra-sound guided, VASER-assisted, Power Assisted Liposuction, the PMMA or silicone is identified and isolated with the ultra-sound.  Then, the VASER melts the scar tissue around the PMMA and silicone.  Then, using powered assisted liposuction, PMMA, silicone, and scar are removed.  If you have more extensive buttock scarring, and there is PMMA or silicone throughout your buttock, you may need direct excision.  Depending on where the PMMA or silicone is on your buttock, you may either need an incision across the top of the buttock or under the buttock.  During their silicone removal procedure, a substantial amount of PMMA, silicone, and scar tissue is removed under direct visualization.    I hope that I have answered your question regarding what to do about removing PMMA from your purple stained buttocks.  When researching for the appropriate plastic surgeon, please seek a plastic surgeon certified by American Board of Plastic Surgery and has extensive experience in removing PMMA, silicone, and other products from the buttocks, breasts, face, and thighs.  Travel out of state if you must to find such an expert. If you have any more questions regarding PMMA or silicone removal from the buttock or other body parts, 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, and American Academy of Cosmetic Surgery.)

Hi Kay_Sweetness!

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 PMMA hydrogel or possibly something else entirely, since unregulated injections often involve mixed or misrepresented substances. If you're experiencing purple discoloration (seeing purple circles), 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 PMMA/biopolymer is causing inflammation or granulomas, you may need surgical removal. If there's pigmentation and material (PMMA, silicone, biopolymer) present under the skin and it’s causing an immune response, microneedling might actually aggravate the issue or cause further migration. It should only be done after imaging and evaluation. Laser treatments, microneedling + topicals might also be used (but only after confirming there's no active inflammation or PMMA migration).

Here at my New York based silicone removal center, 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 get the ball rolling to see how we can help. (516) 279-2616

Silicone in the buttocks and soft tissue can cause inflammatory
reactions. Our office specializes in the management of Karamanoukian
Grade I-IV reaction in the soft tissue using minimally-invasive means.
The first step is to identify the grade of soft tissue reaction and
determine whether the tissue can withstand surgery. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

I would go see a plastic surgeon. You need an mri to evaluate your buttocks and see where this product is in your soft tissues. If it’s localized to one are it can be removed by liposuction or cutting it out. It will leave an indent though and likely need a fat transfer from another area to correct. On a side note, I realize people have these injections done as it’s cheap and sounds great and easy but I’m always surprised when I hear that the injections were done by a random lay person in a hotel room. Does that not set off bells in your head like STOP or CAUTION or RUN? It would scare me half to death letting some random person stick needles in me in a motel. Look up a few American board of plastic surgery certified surgeons and go get expert trained safe opinions. You may have to search a bit though as it’s not an easy thing to fix.Cheers and let us know if we can help

I'm troubled by the fact that a lay person was able to procure and inject a hopefully medical grade substance without proper training or licensure in Toronto. It would be helpful to know what was injected.  PMMA spheres are not silicone. Any long lasting injectable can form chronic subacute nodules that represent a chronic infection of some type. In order to best treat this, a plastic surgeon or dermatologist familiar with these type of situations would be your best bet. Steroids, and or excisions may be necessary to remedy this situation. Best of luck.