On Tuesday, the Food and Drug Administration released a dire warning: Don’t even think about using injectable silicone for cosmetic surgeries to pump your butt or boobs.
“Beware of any one offers to increase the size of any part of your body, or change the shape of your body, by injecting dermal fillers,” a PSA-style video released by the FDA states. “These procedures can lead to serious health consequences, and even death.”
Traditionally, a breast or buttocks enhancement usually requires the surgeon to take some fat from another part of your body to the location you desire to be fuller. Given cultural norms that celebrate—indeed, fetishize—larger, fuller breasts and buttocks, it’s no surprise that these two augmentations are the top cosmetic surgeries in America, with rates for butt enhancement skyrocketing in recent years, no small thanks to celebrities like Kim Kardashian. They’re costly, too: The average butt lift clocks in at $4,571, while the average boob lift rings in at $3,719. Recovery time lasts several days to a few weeks.
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That makes injectable silicone an attractive option for many people seeking alternatives to plastic surgery boutiques. It’s a lot cheaper—most customers buy fillers on the Internet, with prices ranging from a few hundred dollars to about one grand total. While injectable dermal fillers have been approved by the FDA as medical devices for facial cosmetic surgeries (easing out wrinkles in the cheeks, plumping lips up), they are not approved for “large-scale body contouring”—what butt and boob lifts would fall under.
When most people hear the term “silicone,” they're probably thinking of the suction cup looking inserts that many women get for breast implants, meant to bump up cup size.
But injectable silicone is very different, and there’s no real uniform definition of what it exactly is, especially for silicone that's not medical grade. It can take the form of “aircraft lubricant, tire sealant, window caulk, mineral oil, methylacrylates, petroleum jelly, or other substances,” according to a 2012 study that found transgender women dealing with an HIV/AIDS epidemic partially due to these injections. Because many of these cosmetic surgeries are often done without a medically trained individual or someone looking to work under the table, the injections are often unsupervised and rely on liters—yes, liters—of silicone being put in the breast or buttocks without sterilization, often at so-called “pumping parties,” which allows transgender women to attain the curves most associated with being female without the judgment and stigma that comes with being transgender. According to the University of California, San Francisco, rates of transgender women who use injectable silicone are somewhere in the 20% to 50% range.
The fact that injectable silicone is a liquid is a huge problem as well. Liquids move, unlike the silicone cups that are slipped in boobs for an implant. That’s what makes injectable silicone particularly dangerous: The liquid can easily slip into the bloodstream and move. It’s a permanent liquid, too, which means that it can plug vessels that lead to other parts of the body, like the lungs, heart, or brain. If silicone obstructs the flow of blood, a person is at risk of not just a stroke, but potentially, death.
What’s more, there’s a fundamental difference in the constitution of fat and injectable silicone within the body. FDA-approved silicone is designed to stay put where it’s placed in the body; fat naturally, stubbornly stays in place, as anyone with a potbelly knows. Both silicone cups and fat are pliable and soft. Injectable silicone, however, can become hard and gravel-like, which means not only are you dealing with the risk of wandering liquids floating off to places that they shouldn’t be, you're also dealing with a final product that gets chunky and gravelly.
That’s not to say that injectable silicone treatments haven’t worked in the past. But cheap options have their costs, and one major one is that it can take a few tries after the initial injection to get the desired effect. Plus, side effects don't always show up immediately: Injectable silicone has the unpredictable quality of being able to travel at any time.
Here’s the scary thing though. While you might personally know about the dangers of injectable silicone going into your body, your surgeon might try to cut costs and use it during a procedure. Of course, that makes anesthesized humans are unable to watch their surgeon switch into Dr. Jekyll mode and dump some silicone into you to save money.
The other, more worrisome, implication is the role silicone injections have in surgeries for transgender individuals who are transitioning, primarily for individuals who are born men who are becoming women. They’re put in an especially dangerous position because of high murder rates and high poverty rates. For a vulnerable population desperate to have its members fit into traditional constructs of femininity to literally survive, injectable silicone is a risk worth taking.
Which has us back to the FDA warning: Botched surgeries are on the rise and have become increasingly common, with unsuspecting patients either suffering from serious injuries or dying. “The FDA is aware of cases where patients have received injectable silicone for body contouring purposes, such as gluteal or breast enhancement (‘butt fillers’ or ‘breast fillers’), by unqualified providers posing as doctors or licensed healthcare practitioners in non-clinical settings such as residential homes or hotels,” an official alert said. “The FDA is aware that some injectors have falsely told consumers they were receiving an FDA-approved dermal filler, but consumers were instead injected with silicone.”
The scientific literature has been following the worrying epidemic of silicone injectable-induced embolisms and death for a few years now (with some experts putting the death rate from silicone injectables at about 25% of patients who get the procedure), but the fact that the FDA has come out to warn about it explicitly means that not only are consumers at risk but that shoddy practitioners have become ubiquitous enough to involve not just the FDA, but federal officials investigating for criminal activity.
And that’s the crux of why the FDA has issued this warning only now. While getting a boob or a butt job has lost some of the stigma it used to have, the fact that patients are at risk are so vulnerable—they sometimes don’t even know they’re getting injected with something that can clog their veins and kill them, and transgender patients often don’t have anywhere else to turn and are willing to just take the life or death risk of a makeshift hotel operating room—makes this a warning that’s not so funny so much as frightening.
