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First of all, for anyone out there who is considering a silicone injection but hasn't had it done yet, please don't. There are just too many things that can go wrong. The chief problem is fly-by-night "plastic surgeons" who may have a medical license, but don't have any training in cosmetic surgery. Sometimes patients are injected with industrial grade silicone, the kind used as a lubricant on car and truck parts, not the kind that is safe inside human tissue. Medical-grade silicone is pure dimethylsiloxane. It's also used as a lubricant; every modern syringe is lubricated with this product, so just about everyone has some amount of dimethysiloxane in his or her body. Diabetics accumulate about an ounce (25 to 30 grams) of silicone from insulin injections over the course of a lifetime. 

When silicone is injected in amounts large enough to make a bubble butt, however, the body attacks it as if it were an infection. The immune system sends out giant white blood cells called macrophages. The macrophages attempt to "eat" the silicone, but they can get stuck in the blood vessels around the implant. Still more macrophages come out to remove the first wave of macrophages, get stuck, and so on. The result is a lump of dead white blood cells and scar tissue that hurts all the time. Aspirin and ibuprofen are often not enough to make the pain go away. The mass of silicone and scar tissue can make an unsightly "butt bump" that has to be surgically removed, or it can work its way to the surface where it eventually breaks through the skin. The buttocks may tug to one side so that the infragluteal crease (butt crack) becomes uneven or crooked. The rounder your buttocks are, the more prominent any scar across them will be. At this point the problem becomes even worse if the open wound becomes infected. Because the original procedure was cosmetic, health insurance usually does not cover removal, and may not cover treatment for infection, which in the United States can require days or weeks in the hospital on IV drugs at a cost of several hundred thousand dollars.

In other cases, the immune system can go on permanent "high alert" after it detects silicone, and start generating inflammatory hormones that damage skin and joints elsewhere in the body. Silicone can trigger an autoimmune disease called Sjögren's syndrome, and it can be a major factor in the development of rheumatoid arthritis.

Did I mention that it's never a good idea to get silicone injections into the buttocks?

If you already have silicone butt injections, here's what you can do:

  • See your doctor about closed capsular rupture. Do not try this without seeing a doctor first. Sometimes the silicone is surrounded by just a thin layer of scar tissue, and it can be squeezed up and out of the buttocks. In some cases, this is something you theoretically could do at home, but don't try it without getting specific instructions from your doctor. You want to avoid squeezing silicone into even more of your buttocks, and you want to avoid infection.
  • See your doctor about liposuction. Instead of removing fat, the doctor would use the procedure to remove silicone. This is a relatively safe approach to the problem, but more than one session may be necessary, and each session can cost thousands of dollars.
  • See your doctor about surgery. You probably want to avoid surgery, but the longer you wait, the worse the problem becomes. Usually surgery is the only way to remove a heavily scarred implant.

If you want a "beautiful" butt, what are some better ideas? See a board certified plastic surgeon about suctioning fat from one part of your body and injecting it into your buttocks. Your own fat is non-toxic, and your body won't reject it. The doctor may also be able to use a bioidentical product like stabilized hyaluronic acid if you don't want to have liposuction. Or see a plastic surgeon about a "butt flap" procedure, basically a buttocks lift, which tightens the skin in some places and loosens it in others. Just never, ever, ever get silicone injections. They simply aren't safe.

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