Dr. Domingos Q. De Paola

CRM i52.106980-2

​- Full Member of Brazilian Society of Plastic Surgery - SBCP;

- Member of the International Society of Plastic Surgery - ISAPS;

- Member of the American Society of Aesthetic Plastic Surgery - ASAPS;

- Member of the American Society os Plastic Surgery - ASPS

- Member of the American Academy of Cosmetic Surgery - AACS;

- Member of the International College of Surgeons - FICS;

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93 Siqueira Campos Street - Suite 605

Copacabana Medical Center Building

Rio de Janeiro / RJ - Brazil

Phone : (21) 2256-3768(21) 2235-6013

Whatsapp: (21) 2256-3768 / (21) 99994-8124

domingosdepaola@hotmail.com

Monday to Friday from 09:00am to 07:00pm

Industrial Silicone and PMMA Removal

      We have been doing, for more than 20 years, the removal of industrial silicon from the body plus other exogenous materials like hydrogel, bio-gel, shyntol, PMMA mineral oil, Metacrill, Aqualift and others. Of course, each of these products has specific characteristics for example it spreads through the body which makes the surgery of its removal specific to each product.

 

      The most common is the industrial silicone and, luckily, is also the best result we achieved in the removal. Of course, you can’t guarantee 100% removal of NONE of these products because many of them adhere to the skin or muscles making complete removal impossible.

 

      The removal percentage also varies greatly from case to case. We found extremely rigid products like PMMA (Metacrill or Aqualift) and mineral oil that form an extremely dense tissue that has to be removed in rigid "pieces" which almost always leads to some postoperative deformity while others, such as bio-gel and liquid silicone, are easily shaped during withdrawal with special cannula leaving no sequelae and often greatly improving the local aesthetic result.

      Even with these products there are gradations depending on the application time and amount applied because one of the most common complications are the spots on the skin caused by the venous compression that normally fades removing the product, in the same way the sciatic nerve compression pain also fades with the removal of the product.

 

      All surgeries performed with the intention of removing these products are intended to improve the problems caused. We always clarify for patients that they are doing a reconstructive not an esthetic surgery, it is clear that we seek to achieve a good aesthetic result in all but this is not always possible!

      All these products, when applied in the body provide immediate aesthetically excellent results, especially in the butt region, problems begin to appear over time. It's a time bomb! There are patients who present symptoms immediately after the application and others only years later, but fatally at some point in life problems will appear.

Usually these applications are performed by lay people and is known, since there have been several cases of death after the application.

Other than this would be the biggest problem, there are others such as:

• Moving product that changes place, the most common is when used on the buttocks go down to the thighs, legs and feet, often leaving the feet looking like elephant foot (elephantiasis);

• Skin and adjacent deformities causing skin and product to fall, altering the entire contour of the body;

• Changes in color and consistency of the skin, turning a red color that becomes dark and taking on the appearance of the orange peel;

 

• Very serious and difficult to control inflammations and infections, with only systemic drugs;

• Skin necrosis may also happen in the most severe cases;

• Circulatory changes in affected areas.

• Sometimes, especially in inflammatory crises, they lead to difficulties in locomotion.

       

 Removal of Permanent Facial Fillers

     

      We also remove fillers on the face, the most common being PMMA (Metacrill or Aqualift) with surgeries similar to the facelift and sometimes also inside the mouth.

      The surgery for the removal of PMMA from the face consists of an undermining of the facial skin, in a technique similar to the facelift. The altered tissues, due to the product, are then individualized and removed with all the care and delicacy necessary to avoid problems of injury to the nerves of the face. In the central areas of the face such as the naso-bucal groove and mandibular areas we withdraw from the inside of the mouth to avoid nerve damage. Often, in these cases, a second surgical time is necessary a few months later to correct possible depressions caused by removal using fat grafting technique.

 Removal of Gluteal and Thigh Silicone

      For the removal of silicone and similar products from the butt region and thighs, we usually start the procedure aspirating the product and all the fat from the subcutaneous tissue where the product is soaked using a specially made cannula. If we use regular liposuction cannulas we will remove the fat and leave the silicone.

 

      After this we will make a "fleur-de-lis" incision in the upper portion of the butt and inside the bikini mark. Through this incision the entire area is undermined and once again we remove as much of the product as possible with special curettes.

 

      At this time we have two options:  make a small skin flap to give some filling to the butt, now completely emptied, or put a silicone implant inside the gluteal muscle to reconstruct the region and try to reach a similar result to the preoperative. This done we pulled the skin fully upward to raise the entire buttock and the incision is closed with internal stitches and surgical glue.

 

      We always leave a suction drain in the undermined area!

      We have worked with this type of surgery for more than 20 years with very positive results.

Common questions

1- What is the type of anesthesia and length of hospital stay?

A: In the face, the anesthesia is local with sedation and the hospitalization can last from 12 to 24 hours.

     In the body the anesthesia is epidural with sedation and the time of hospitalization is also 12 to 24 hours.

2- How long to return to normal activities?

A: Depending on the length of the removal the recovery can last for about 15 days. To return to physical exercises, they are usually released after 30 days.

3- What is the expectation regarding pain?

A: The postoperative is only painful if the implant is placed in the same surgical time, it still lasts about 3 days and can be easily controlled with codeine analgesic.

5 - Are there any points to be removed?

 No. Every suture is internal and over the wound we use a glue that stays for 15/20 days protecting the area and allowing to shower in the first few days.

6 - Does surgery to remove liquid silicone ensure that I will not have any more inflammatory or other silicone related problems?

 

A: In the vast majority of cases, yes, but we can’t guarantee that there will never be any more reactions because it is never possible to remove 100% of the liquid fill. What we can say from our experience is that the higher the withdrawal the lower the frequency of all types of adverse reactions caused by silicone, this is one reason why there are cases where more than one surgery is necessary.

3D step-by-step virtual procedure, see below:

Post-operative Timeline

7-10 days

14 days

21 days

30 days

6 months

Drain is removed

Initiate lymphatic drainage

Permitted to sit and lay on top of the implants

Physical exercise and beach is permitted.

Magnetic resonance imaging for evaluation of results