The War on Silicone
Dr. Kenneth Hughes, Harvard-educated, Harvard-trained, board-certified plastic surgeon in Los Angeles, has performed many, many silicone removal surgeries from patients around the world. For this patient, Kenneth Hughes MD removes several pounds of injected material and scar tissue. This video shows the pounds of injected material and scar tissue on the back table in the operating room.
The preservation of the skin envelope in a surgery like this is no easy task. The skin, fat, and sometimes muscle is diseased, the blood vessels are diseased, and healing will be compromised. The surgery has to be executed astutely and meticulously to allow for a patient return to normal life, and there are no guarantees that the material removed will produce the results that the patient expects. In addition, there is no certainty that an area can be reconstructed to create a cosmetically pleasing result.
Make no mistake – this is a war to save people and the plastic surgeon is leading the charge. It is not a war in which anyone wants to get involved. The patients are filled with regret at decisions to receive the injections, and the plastic surgeon is nervous that the surgery will not produce the results the patient expects. When the silicone material is injected, usually by an individual with no or very little training, there is a significant risk for patient death. These patient deaths occur when the material like the silicone enters the bloodstream and gets lodged in the lungs. If the patient survives the silicone injection, the problems continue. There is such tremendous variability in amount and type of materials as well as tissues injected along with an individual’s reaction to the material that no two individual cases are the same and no two surgeries are the same. This also means that no two recoveries are the same. Adherence to Dr. Kenneth Hughes’s recovery protocols is paramount to healing as well as possible and avoiding a host of complications.
These surgeries are extremely difficult and laborious, and Dr. Hughes does not enjoy performing the surgeries at all. However, these are surgeries, which have manifold health benefits to the patients. Some of the patients have pain, difficulty sitting, hardness, skin changes, infection, systemic illness, generalized swelling, and distant pain syndromes. Kenneth Hughes has observed improved pain, improved systemic complaints, reduction in swelling, and improvement in skin and tissues as well as resolution of tissue hardness. There are many risks to the surgery including infections, fluid collection, skin loss, need for revision, need for reconstruction, etc.
When the removal surgery is finished, the recovery process will dictate the time at which reconstructive surgery may begin. The earliest that any reconstruction can be performed is about 3 months later though some patients may not heal well after removal due to the damage that has been done to the tissues by the foreign material injected. Patients should realize that the reconstruction is not as simple as pumping up a deflated tire on a bike and any fat grafting surgery must overcome intrinsic skin envelope tightness coupled with scar tissue inflexibility. Fat transfer techniques referred to as Brazilian buttlift or BBL can be utilized to help reconstruct these defects. Other techniques such as free tissue transfer or local flap rotations are also options. Finally, butt implants may be an option as well.