Silicone Removal: Why?
Illegal use of injectable silicone for body contouring is associated with significant health risks. The FDA has issued several consumer warning notices to bring awareness to the unauthorized marketing and use of these products. Studies have reported a range of dermatologic complications, including: lymphatic and subcutaneous migration of silicone (59%), inflammation (50%), varicose veins (39%), post-inflammatory pigmentation (20%), infection (14%) and abscesses (4%). Other studies have associated liquid silicone with devastating and irreversible kidney injury. Complications from silicone injections can occur almost immediately but can also present decades after injection.
If you have received silicone injections, you might wonder what can be done to help mitigate the health problems associated with liquid silicone. One option may be silicone removal and reconstruction. Silicone removal and reconstruction are commonly performed in two distinct phases.
What is the Process for Removing Illegal Silicone?
Phase 1 involves removal of the silicone. Because liquid silicone migrates, many patients require removal of the silicone in several staged surgeries. For this same reason, it’s rare that 100% of the silicone can be removed. However, patients typically receive medical benefit and improvement in symptoms when most of the silicone is removed. There are several different surgical approaches that can be used. Sometimes silicone removal can be accomplished with large liposuction cannulas. Other times, incision(s) must be made with a scalpel to remove the silicone and granuloma/scar tissue. Many times, both liposuction cannulas and direct incision are performed during the same procedure.
Phase 2 involves reconstruction after most of the silicone is removed. Reconstruction is often needed because the area typically appears “saggy.” This is why reconstruction commonly focuses on lifting and tightening. Classically, patients required an extended seagull-shaped incision that is placed on the upper buttock below the bikini line. This lifts the buttocks vertically. However, less conspicuous scars are possible using the Miami Thong Lift approach. The Miami Thong Lift places the scars vertically in the intergluteal crease. Note, some patients may only require fat grafting to correct for the lost volume after silicone removal. For certain patients that prefer to avoid additional fat grafting surgeries, our practice offers the latest cutting-edge technology. Specifically, Renuva® and Leneva®. These products are long-lasting FDA-approved adipose matrix fillers. These injections are performed in the office without a scalpel or general anesthesia.
Before embarking on this journey, your surgeon should work carefully with you to develop a custom surgical plan and explain the process in detail. Silicone removal consultations can be 1 to 3 hours and are charged based upon estimated time. During this visit: 1) a detailed medical history will be taken; 2) imaging such as an MRI, MRA, or MRV may be reviewed or ordered; 3) wound cultures may be taken to help select appropriate post-operative antibiotic coverage; 4) Phase I and Phase II surgical markings will be drawn on the patient to discuss scar placement; and 5) post-operative wound care such as a possible wound VAC will be discussed. At the conclusion of the visit, you will be given a quote for the removal, reconstruction, and associated costs. While patients pay out-of-pocket for these procedures, we recommend that all patients have health insurance for third-party vendors to cover items such as pre-operative imaging, wound cultures, and prescription medication from the pharmacy.
