Black market injection of foreign substances into the buttocks has become big business throughout the US and in other countries. This is an unregulated practice as it is not performed by plastic surgeons and the substances are not FDA approved for injection. There are significant risks associated with these injections including skin death, skin changes, chronic pain, cosmetic deformity, infection that can become severe and lead to death.

However, the desire for larger buttocks and hips at a low cost is attractive to many. Frequently, the individual performing the injections has performed the injections for a friend or family member and that is how the process propagates. Under no circumstances are these injections a good idea nor should they be performed.

With the deluge of black market injection patients to plastic surgeons for removal of these materials, all sorts of removal techniques have been recommended. Having performed many of these primary removals and an even greater number of revisions of attempts at removal, I can tell you that in almost every case the materials must be removed by literally excising them, or cutting them out directly. The reason for this is the simple reason of density. The density of these foreign materials is greater than the surrounding fat and thus liposuction removes fat without really addressing the substance. Even when the substance is of similar density a blind liposuction approach causes much more removal of native fat than would removal of the material itself.

In fact the goal should be removal of as little native or intrinsic tissue as possible to reduce the chance for deformities or the need for further revision procedures.

Though the bad practice of black market injections is unlikely to cease, the removal of these substances should be done in precise fashion to limit the potential damage.

Dr. Kenneth Hughes, MD
Board Certified Plastic Surgeon

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