Black Market Booty: The Risk of Illegal Butt Injections
While not everyone will be able to break the internet with a killer backside, à la Kim Kardashian, women seeking a rounder derrière have options to improve their silhouette. Gluteal enhancements are on a steady rise in the US, and they’re extremely popular in other parts of the world as well. According to the American Society for Aesthetic Plastic Surgery, the number of buttock enhancements increased by a staggering 86% in just one year from 2013 to 2014 and the trend continues to be pervasive. I’ve even daydreamed of removing my bit of tummy flab and adding it to my rear to both slim down and shape up simultaneously! (More on that later).
This skyrocketing demand for bigger backsides has created a vibrant black market of dodgy characters offering highly dangerous injectables with substances like concrete, cooking oil or tire glue--which can lead to major health risks that can result in decay, disfigurement or death.
Intrigued, I recently spoke with board-certified plastic surgeon Dr. Adam Rubinstein who has performed gluteal enhancements at his Miami practice for over 10 years. I learned what these black market materials are made of, the scary results they can produce, and why this seemingly “cheap and easy” option is anything but(t)…
Mary: Do these back alley procedures masquerade as legit businesses or are people knowingly choosing to get enhancements from non-certified, unqualified and illegal sources?
Dr. Rubinstein: In Miami, these are pretty commonly done in hotel rooms, which should give it away, but the person with the injection is likely lying about having appropriate credentials.
Mary: Given your extensive experience, why do people jeopardize their health by getting illegal butt injections? Is it always a matter of price, or do you think that some people don't know that they are allowing unapproved substances to be injected directly into their body?
Dr. Rubinstein: Price is the primary reason; people get the shape they want, for a short-term fix. Recipients likely know that this is illegal and realize that they are making a compromise. Illegal practitioners set up shop in hotel rooms and injection recipients may see it as just a cost saving mechanism because they don’t have to pay hospital fees, but they don't realize that is not even the reason they’re in a hotel room. Put simply, it’s all illegal. Medical care should not be given in a hotel room or living room unless it’s a matter of life or death and 911 has been called in.
Recipients are swayed by the drastic difference in price. [Injections might be priced around $200 a shot, while a safe procedure with a board-certified plastic surgeon can range from $8,000-$12,000.] Some patients don't understand why they should pay to get it done properly, and because the ill effects don’t show up immediately, people get away with it.
Mary: What are these fillers made of?
Dr. Rubinstein: They can be non-medical grade, industrial silicone. Not only is this non-FDA-approved silicone, it’s free flowing, not contained within a gluteal implant, which means it will likely migrate to other areas of the body.
Sometimes the material is called “biopolymer,” which is just a catch-all term for anything other than silicone. Sometimes the black market material is a substance that’s been approved in other countries - but remember there's a reason that it's not approved in the US.
And then some of the really awful cases of underground substances in Miami have ended up being “Fix-a-flat” tire glue and cement. Sometimes it’s cooking oil! You don’t know what you’re going to get. Rare is the case that an illegal, non-licensed person is filling people with legal substances. It’s nearly always a person performing procedures illegally, using illegal substances.
Mary: Can you briefly describe a worst-case scenario that you've seen in patients who have come to you for reconstruction after getting off-market fillers?
Dr. Rubinstein: A young woman who came to me had gone to a hotel room and had silicone injected into her buttocks. It was an awful mess. There were numerous operations to scoop out all the junk, remove dead tissue and treat infection.
At the end of the day people seem embarrassed, and carry a lot of guilt. In my experience, they have a hard time even admitting to it.
Mary: How often are you contacted by someone who has had an illegal butt enhancement?
Rubenstein: At least once a month I get a call or visit from someone who has had an illegal treatment. And that’s just at my practice!
Mary: For those who don't know - what are the responsible, safe and recommended ways to enhance one's backside, and is there one procedure you prefer and recommend more often?
Dr. Rubinstein: Fat grafting. It is the best way to create a natural contour, and carries the least amount of complications. But you have to have enough fat to do it. Implants are an alternative, but I don’t perform that procedure at my practice because it has a higher complication rate.
Mary: I’ve always dreamed of removing my slight roll of exercise-resistant belly fat and adding it to my backside. Would I be a candidate for the procedure?
Dr. Rubinstein: It takes a significant amount of fat to change a contour in a worthwhile way. Since we generally inject at least 500 ccs of fat on each side, we have to harvest as much as two liters from areas around the body to end up with one usable liter of re-injectable material.
Mary: Where is it taken from, and how?
Dr. Rubinstein: Liposuction all over the body.
Mary: So it's like a double operation in one!
Dr. Rubinstein: Yes, the patient will decrease all over, in addition to having the contour of the butt enhanced.
Mary: Have you seen a “Joan Rivers effect”? Are people becoming more diligent in researching who is performing their surgeries and demanding the correct credentials?
Dr. Rubinstein: People have become more aware and are better consumers within the last 5 to 10 years. Public awareness is improving but it’s nowhere close to where it needs to be. People still don't really know the difference between a plastic surgeon and a cosmetic surgeon, and they don't know to look for board-certified plastic surgeons.
And of course, as people get savvier and know what credentials to ask for, the charlatans have become savvier, claiming to be board-certified of an unknown organization. Use the Smart Beauty Guide directory or check out Certification Matters The site is run by the Accreditation Council for Graduate Medical Education You can check the site for a report on doctors you are considering to make sure that they are not only board-certified, but are accredited in the appropriate area practice.
…Because we wouldn't want our board-certified gynecologist performing plastic surgery procedures! Thank you for your time, Dr. Rubinstein. As always, it was great speaking with you.
Dr. Rubinstein is a board-certified plastic surgeon based in Miami, FL. For more great advice from Dr. Rubinstein, tune in to his New Reflections radio show.