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Reply to Dr. Pierones Question Re: My Post

Oct 11, 2010

Dear Dr. Pierone, thank you from my heart for taking the trouble to answer my question: <a href="/Forums/AIDS/FacialWasting/Current/Q211046.html" target="_blank">Does PMMA Cause Severe Buttock Hardening?, dated September 27, 2010</a>. Your reply was both reassuring and at the same time troubling.

In answer to the interest you expressed in what my plastic surgeon recommended as an alternative to PMMA as a restorative treatment for my buttocks, he suggested that we use the same materials he used to plump up my face Sculptra and silicone. He has treated my face three times with the concoction and the results are quite pleasing, though from reading mostly in The Body I am coming to realize that perhaps the results are not going to be as lasting or permanent as he has implied.

Response from Dr. Pierone

Hello and thanks for posting.

The use of silicone for soft tissue augmentation is well established and the method currently used is a micro-droplet technique. The idea is that by using very small injections of silicone, these micro-droplets will be held in place by the body's inflammatory reaction to prevent silicone migration.

The use of micro-droplet technique for silicone placement is not feasible for buttock restoration because of the volume required. One risk of injecting larger volumes of silicone into the buttock region is that the silicone may migrate and product injected into the buttock may end up years later in the thigh and lower leg. How often does this happen? No one really knows. The medical literature is replete with complications from large volume silicone injection, but for every reported case there are likely many patients who do well.

I spoke with your surgeon and he told me that he has not seen any problems using large volume silicone for buttock restoration and had treated about a thousand patients. When I asked him how he made the procedure cost effective, he told me that he had received a large amount of medical grade silicone from a prior research project and this enabled him to make the procedure affordable.

It sounds like your surgeon offers a treatment that is not generally available due to the cost of medical grade silicone. He reports extensive experience with this treatment and reports good results. However, the many reports of silicone migration in the medical literature raise red flags.

The use of PMMA for soft tissue augmentation has a long track record and migration has not been an issue. This is an option for buttock restoration, but is not available in the United States.

I hope that this information helps and best of luck to you!

CD4 Criteria for Sculptra/Radiesse?
Does Sculptra stop working after long-term use?

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