After getting silicone removal can too much gluteus muscle be removed or damaged causing to be ineligible for a fat transfer?

Question

Silicone/ Biopolymer removal

Carlos Alberto Ríos García, MD · Answer

I understand your concern. In complex silicone removal cases, especially when the material has infiltrated deeply into the muscle and surrounding tissues, some degree of tissue loss can unfortunately occur during the removal process.
The goal of surgery is usually to remove as much problematic and inflamed material as safely possible while preserving healthy tissue, blood supply, nerves, and structural support. However, when silicone is extensively mixed within the gluteal muscles, fascia, fat layers, or scar tissue, surgeons sometimes must remove portions of damaged or heavily infiltrated tissue to control ongoing inflammation or prevent further complications.
That does not automatically mean a patient becomes permanently ineligible for fat transfer, but it can significantly affect:
* how much healthy tissue remains* blood supply quality* skin elasticity* scar formation* tissue thickness* and how safely future grafting could be performed
In some patients, staged reconstruction with fat grafting may still be possible later once healing stabilizes. In others, the tissues may become too scarred, thin, poorly vascularized, or structurally compromised for large-volume fat transfer to behave predictably or safely.
Timing is also extremely important. Attempting aggressive reconstruction too early after major silicone removal can increase the risk of poor fat survival, contour irregularities, wound healing problems, or additional inflammation.
Without imaging studies and examination, it is impossible to determine how much tissue involvement exists or what reconstructive options may realistically remain afterward. Cases involving deep silicone infiltration often require very individualized long-term reconstructive planning focused not only on appearance, but also on preserving function, circulation, tissue viability, and structural stability as much as possible.

J. Timothy Katzen, MD, FACS · Answer

Hi My Surgical Journey, thank you for your question regarding whether, during silicone removal from the buttock, can too much gluteus muscle be removed or damaged, causing it to be eligible for fat transfer. When injected, silicone can be injected into the buttock fat and/or muscle, namely, the gluteus maximus muscle. Usually, the depth of silicone injection into the muscle is, at most, 1 to 1.5 inches into the gluteus maximus muscle. The gluteus maximus muscle is the largest muscle in the buttocks. Even if the outer 1.5 inches of muscle is removed, you would still be eligible for a BBL or fat transfer to the buttocks. During fat transfer to the buttocks, fat is injected into the fatty layer of the buttocks. Fat is not injected into the gluteus maximus muscle. Therefore, fat is injected into the fatty layer to reconstruct the buttock after silicone removal. Fat should not be injected into the buttock muscle. During a BBL, if fat is injected into the gluteus maximus muscle, the injected fat can cause lethal fat emboli or clots in the lungs. Therefore, experienced and knowledgeable plastic surgeons do not inject fat into the gluteus maximus muscle during a BBL, especially during buttock construction after silicone removal. Therefore, even with significant gluteus maximus muscle removed, you can still be eligible for fat transfer. I hope I have answered your question regarding whether you can get fat transfer into the fatty layer of the buttocks after  gluteus maximus muscle removal for the removal of silicone injections into the buttocks. Good luck.

Jeremy S. Nikfarjam, MD · Answer

Hi MSJ,
I treat hundreds of patients each year who are suffering from silicone and silicone diseases. I also treat many many silicone removal revisions. I have never seen a patient rendered ineligible for fat transfer. That said, the one thing I do know to be true is that no two silicone patients are alike, and this substance does things to the body that no one in the medical community fully understands. 
Every one of my silicone removal patients have successfully undergone subsequent reconstruction with fat transfer. 
It sounds like you've already been through a lot. I hope you find the care you're seeking soon.
- Dr. Nik

Darryl J. Blinski, MD · Answer

Yes there is a very high risk if too much gluteal muscle has been removed. Best to virtual consult with. To see if ultrasound guided fat injections can be easily done in surgery. Expect fees from $10,000+ Again try to virutal consult with....

After getting silicone removal can too much gluteus muscle be removed or damaged causing to be ineligible for a fat transfer?

Answers (4)

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