Silicone Injection Fact Sheet

• Silicone can be a free oil or can be in a capsule, like a breast implant.  
• If it was put in your body with surgery, it is an implant. 
• If it was injected, it is free silicone. Injected or free silicone sometimes is mixed with harmful substances such as bathtub caulk, motor oil, cooking oil, mineral oil, or cement glue- even it was described as “medical grade.” 

Most medical professionals and the Federal Drug Administration (FDA) agree that silicone injection is dangerous.1 

• Silicone can cause infection after it is injected, and might cause life-threatening blood clots, including a condition called pulmonary embolism where a blood clot gets stuck in the lungs.  
• As silicone ages in the body, it can move to different areas (migration), like silicone in the hips falling down into the ankles or silicone in the cheekbones falling down into the cheeks.  
• Silicon can also cause severe pain as it shifts and moves.  
• Silicon hardens as it ages and may create hard knots (granulomas) under the skin and a dimpled appearance of the skin.  
• Silicone can be very difficult to remove once it has been injected, which means that these changes may cause chronic pain and other health complications. 

• Being aware of the possible complications related to silicone injections (such as those listed above) and recognizing these symptoms is an important first step in seeking appropriate treatment. 
• Not knowing what’s going on with your body and the silicone inside it can be scary. Talking with a knowledgeable medical provider is important.  
• Your provider can also check whether your silicone is causing side effects by doing certain blood tests including calcium and markers for inflammation. But there are other things, like HIV, that can cause these labs to change. 
• If you got your silicone a long time ago, and it’s not bothering you, it’s probably ok to keep it. 
• If you are in pain, you can ask your medical provider for treatment of your pain. 

The short answer is maybe. 

• You don’t have to remove injected silicone if you don’t want to! 
• Silicone removal may require surgery. Surgeons often have physical requirements before they operate. For instance, if you have a chronic condition like diabetes or HIV, they will want to see information showing those are being well-controlled. Some surgeons have weight limits, and many will not operate on people who smoke cigarettes. They may check your urine (pee) for nicotine from any tobacco source. 
• There is no such thing as the perfect patient for silicone removal. Surgeons will look at your body, where the silicone is placed, how deep or shallow it is, and your health overall.  
• It may be more dangerous to get silicone removed than to leave it in your body for the long term. 
• It is still possible to have pain after silicone is removed.  
• It is also difficult to remove silicone and trying to take it out can cause skin problems, wounds that don’t heal, and disfigurement. After removal there is a dip inward where the silicone was making a curve before.  
• Everyone has to make their own decision about silicone removal. You do not need to remove silicone unless it is causing very bad pain or other medical problems. 
• If you are in pain, you can ask your medical provider to treat your pain. If you would like it removed, you can ask your medical provider for more information. 

How to get rid of silicone is a process that depends on how much of it you have, where it is, and what is happening with it. There may be imaging (CT scans) required.  

Where can I learn more? 

• Ask your primary care provider about the options that might be available to you. 
• If you are seeking or already have sought gender affirming surgery, ask your surgeon for more information about what services they might provide. 
• You can also learn more about surgeons who might provide silicone removal  at transatlas.callen-lorde.org  

What does it cost?  

• Insurance will only cover silicone removal if it is causing problems that keep you from living your life. If you are not having major problems from silicone, you may have to pay for surgery yourself. 

Avoid injecting silicone into the legs and feet. For example, silicone injected under the feet to make wearing high heels more comfortable can result in the same long-term problems as silicone injected anywhere in the body. 

Cortisone shots do not provide lasting relief for the discomfort caused by silicone injections, and could be harmful. 

¹ FDA Warns Against Use of Injectable Silicone for Body Contouring and Enhancement: FDA Safety Communication

https://wayback.archive-it.org/7993/20201224130153/https:/www.fda.gov/medical-devices/safety-communications/fda-warns-against-use-injectable-silicone-body-contouring-and-enhancement-fda-safety-communication

Sergi, Francesco D., and Erin C. Wilson. 2021. “Filler Use Among Trans Women: Correlates of Feminizing Subcutaneous Injections and Their Health Consequences. Transgender Health. 6(2): 82-90.See Sergi and Wilson. 2021