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While immigration issues, largely that of the Hispanic and Latino origin, have dominated the national headlines for a while and will continue into the future, there is a cosmetic medical issue also brewing within these U.S. communities. In large urban areas such as L.A. New York and Chicago, this influx of legal and illegals have become prime targets for cosmetic surgery scams.

The desire to have a larger or enhanced buttocks is a common aesthetic desire to the Latin and South American communities. In addition to African-Americans, they make up the overwhelming majority of those patients in the U.S. seeking buttock  enhancement by enlargement. While buttock implants is the most assured and immediate way to increase buttock size, it is major cosmetic surgery that involves significant recovery and expense. As a result, the allure of more ‘simple’ buttock injections is significant with less cost and minimal recovery.

When done by a board-certified plastic surgeon who uses your own fat, buttock injections are perfectly safe and one also gets the benefit of some body contouring from the harvest site. The problem with buttock fat injections is not safety but reliability. Patients often have to be content with less of a size than they want from a single surgery or be willing to undergo multiple fat grafting sessions.

But a subculture of buttock injections exist that uses unapproved silicone oil and is done by nothing short of cosmetic charlatans or black marketers. And they pray upon the most susceptible of patients….the uneducated and those who can not afford the real and proven surgery. The result has been a rash of such patients who have suffered complications including death. From cases in New Jersey to the  most recent one in California,  a pattern of illegal cosmetic surgeries is occurring in the largely Hispanic communities.While silicone is an FDA-approved filler material for breast implants, it is in a gel form that is contained in a bag and placed in a single tissue location. Silicone as an oil only exists as an approved medical procedure for replacement of eyeball fluid. It is not approved by the FDA or has ever proven to be safe when injected into fat. There are some plastic surgeons who may use it off-label as a facial soft tissue filler but for this application only small micro-droplets are injected. Such small quantities may not kill you but it could turn into small hard lumps and look irregular or lumpy. When large quantities are pumped into the buttocks, severe allergic reactions may develop or it could accidentally find its way into a large vein, going to the lungs and creating a potentially fatal embolus or blood clot. When poor quality or low-grade silicone oil is used, or worse some other material, severe complications are inevitable.

Despite these published complications, some patients persist in pursuing these black market buttock enlargement procedures. In my Indianapolis plastic surgery practice I just saw a buttock enlargement consult this week who specifically came in for silicone oil injections. Why she thought I ever did this illegal procedure I do not know. But she was young and naïve and had clearly done no research on the procedure. She was only focused on ‘immediate results that would be permanent’ and ‘she could return to work with no recovery or pain’.When it comes to buttock enlargement, like all cosmetic procedures, stay with the safe and proven. While fat injections and implants may not be perfect, they are safe and are accepted standards of medical practice. The allure of convenience and low cost should be reserved for fast food and coffee, not surgery

Dr. Barry Eppley

Indianapolis, Indiana

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