Biopolymer removal in Valencia: a complete guide for patients

What are biopolymers, and why are they considered dangerous?

In everyday cosmetic-surgery language the word «biopolymers» has become the usual term for injected substances that are not biological in origin but are used as long-lasting fillers. Scientifically the name is wrong, because «biopolymer» implies a molecule of natural origin, such as collagen or hyaluronic acid. In this context, though, it is used for synthetic compounds such as:

• liquid silicone
• paraffin
• petroleum jelly
• mineral or vegetable oils
• animal fat
• methacrylate

Once injected into the body, these materials are not biodegradable. Because they stay there they are a constant source of risk: the body cannot get rid of them on its own, nor can it integrate them without inflammatory changes, infection or progressive deformity.

Adverse effects of biopolymers

Patients who have been injected with biopolymers can experience side effects both immediately and in the long term. The most frequent consequences include:

• granuloma formation and encapsulation
• migration of the product to neighbouring or distant areas
• tissue necrosis and skin ulceration
• fibrosis and damage to muscle or fatty tissue
• chronic infection and abscesses
• the appearance of fistulas
• persistent, disabling pain
• severe allergic reactions
• pigmentation changes (hyper- or hypopigmentation)

What is more, when these materials spread through the body they can reach internal organs or travel down into areas such as the legs, causing serious medical complications that affect the patient’s general health.

One of the best recognised associated conditions is iatrogenic allogenosis, a chronic inflammatory syndrome of external cause that arises in response to these foreign substances in the human body. It can develop unpredictably and calls for immediate medical attention.

Is surgery necessary to remove biopolymers?

Yes. To date there is no non-surgical alternative that removes biopolymers safely, effectively and completely. Some clinics promote lasers or ultrasound; those treatments may partly break up the granulomas but they do not achieve definitive removal of the material. In fact, using them without proper control can make later surgery harder, by changing where the compound sits or by causing further migration.

Surgery is currently the only valid approach to removing biopolymers. Depending on the case, it may be carried out using:

Open technique

This is the preferred approach in the great majority of cases. It allows the surgeon to:

• identify the affected area precisely
• remove the material under direct vision
• resect inflamed or damaged tissue
• carry out aesthetic reconstruction where needed

It may leave visible scars, but the surgeon always looks to place them where they show least. In the buttocks it is usually combined with lifting techniques to improve contour and symmetry.

Closed technique

This technique is based on liposuction through small incisions. It is practically never used, offered or applied in any case, because its limitations are severe:

• it does not allow the surgeon to see the material being removed
• biopolymers are usually encapsulated or mixed with scar tissue, which makes complete aspiration impossible
• if the product has migrated or is deeply infiltrated into muscle, removal is incomplete and the material may be spread further.

For all these reasons, the closed technique is essentially not recommended today.

What does the surgery involve?

At the Instituto de Cirugía Plástica del Mediterráneo in Valencia the operation is carried out under general anaesthetic and takes between 2 and 3 hours, depending on the case. Some cases are done as a day case; others may require an overnight stay.

After surgery the patient follows a strict recovery protocol, which includes:

• wearing compression garments
• local wound care and drain management
• anti-inflammatory and antibiotic medication
• restricted physical activity for the first few weeks
• continuous clinical follow-up

Initial recovery takes about 14 days. The final aesthetic result is usually apparent between 4 and 6 months after surgery.

How can I tell whether I have biopolymers?

Many patients do not know what substance they were injected with. These materials are often applied in premises with no health regulation whatsoever, and no clear information about the composition is given. Even so, biopolymers can be detected by:

• soft-tissue ultrasound
• magnetic resonance imaging
• computed tomography (CT)
• biopsy where there is doubt

Imaging does more than confirm that the product is there: it makes it possible to plan the best surgical strategy, to assess how far the problem extends and to judge whether neighbouring structures are involved.

Why does it matter to choose a specialist clinic?

Biopolymer removal is not routine cosmetic surgery. It is a reconstructive procedure that demands experience, precision and advanced resources. The choice of surgical centre bears directly on:

• the safety of the procedure
• how much material is actually removed
• the prevention of complications
• the quality of the aesthetic result
• the patient’s well-being and recovery

At our centre every case is assessed individually, with prior diagnostic studies, a review of the patient’s clinical condition and detailed surgical planning. We rely on advanced technology, high-specification operating theatres and a medical team with years of experience in surgery to remove permanent materials.

Is removing biopolymers urgent?

Early removal can be the key to avoiding permanent damage. Some patients have no immediate symptoms, but the longer these substances remain in the body the more likely progressive complications become, both functional and immunological. So where biopolymer injections are suspected or confirmed, we recommend that you:

• see a specialist
• have imaging studies done
• have the case assessed for surgery as soon as possible

Delaying surgery can lead to more extensive fibrosis, loss of healthy tissue or irreversible damage. In some cases, however, conservative management is a reasonable option.

Complete care and medical ethics

At the Instituto de Cirugía Plástica del Mediterráneo we understand that many of the patients who come to us have been through traumatic experiences. That is why our approach is a complete one, built on:

• accurate medical diagnosis
• close, personalised care
• safe, effective surgery
• thorough post-operative follow-up
• emotional support throughout the process

Our goal here is to restore the patient’s health, self-esteem and peace of mind, while doing as little harm as possible to the final appearance.

Biopolymer removal is a necessary medical procedure for many people who, in the past, were injected with unauthorised substances. Because the material stays in the body it can cause severe, progressive complications, and surgery is currently the only effective and safe answer.

In Valencia, the Instituto de Cirugía Plástica del Mediterráneo is a point of reference for this kind of surgery. If you are unsure about your situation, if you were injected without being given clear information, or if you have symptoms such as pain, lumps, deformity or persistent swelling, book a professional medical assessment.

Health and confidence can be recovered. We are here to help you.

Frequently asked questions about biopolymers

How much does biopolymer removal cost in Valencia?

Unlike other operations, it would not be honest to give you a price range here: the cost depends entirely on the medical assessment of each case. No two patients with biopolymers are alike.

What makes the quote vary is how much material was injected, how many areas it is in, how far it has migrated, the condition of the tissue around it, whether reconstruction will be needed afterwards and how many surgical stages the case requires. A localised removal and an extensive removal from the buttocks with later reconstruction are nothing alike.

That is why the first step is always an assessment with imaging. With that on the table you are given a fixed, written quote, and that quote is the one that holds. Be wary of anyone who gives you a figure over the phone without having examined you.

What are biopolymers?

“Biopolymers” is the popular name for a group of permanent filler substances injected to add volume — buttocks, breasts, face, hips — that the body cannot get rid of. The name is misleading: it sounds biological and natural, when in fact these are synthetic materials.

Very different things have been injected under that label: industrial liquid silicone, polyalkylimide, methacrylate, mineral oils and even unidentified products. Many were applied outside any healthcare setting and with no traceability, so very often the person does not know what is inside them.

None of this has anything to do with the resorbable fillers in ordinary medical use, such as hyaluronic acid, which the body clears over time.

How do I know whether what I was given were biopolymers?

There are pointers. That the product was described as permanent or “for life”; that a large volume was used; that it was done outside a healthcare facility or without any paperwork; and that you were never given an invoice, a label or a brand name for the product.

If you still have any paperwork from the treatment, bring it to the consultation: identifying the material changes the whole approach.

When there is no way of knowing — which is the usual situation — we turn to examination and imaging. Ultrasound and MRI show where the material is, how much there is and how it has behaved in the tissues.

I had them years ago and I am fine. Why are they a problem?

Because the risk does not go away with time: it builds up. These materials are not reabsorbed and stay in contact with the tissues indefinitely, so complications can appear years after the injection, with no apparent trigger.

In the published series on polyalkylimide, the mean time to the appearance of symptoms is around 13 months, but cases have been described that first presented between 3 and 7 years later.

Being well today is good news, not a guarantee. The sensible response is follow-up, not putting it out of your mind.

What complications do biopolymers cause?

The commonest are granulomatous reaction — the body tries to wall off the material by forming inflammatory nodules, sometimes painful and visible — infection, even very late on, and migration: the product travels under gravity and along the tissue planes into areas where it was never injected.

Hardening and deformity of the area, changes in skin colour, chronic pain, ulceration and fistula formation are also described.

Where large volumes were injected, systemic problems have also been documented, such as hypercalcaemia associated with the chronic granulomatous reaction, which need medical and not only surgical management.

Can they be removed completely?

It has to be said plainly: complete removal is rarely achieved. These materials do not form a defined pocket that can be emptied; they infiltrate between the tissues, mix with fat and muscle and have often migrated.

The realistic goal is not to “take it all out” but to remove as much as possible, excise the damaged inflammatory tissue and give the area back the best shape and function it can have. That alone changes many patients’ lives completely.

Promising a complete clear-out is the surest sign that whoever promises it has not treated enough cases.

How are biopolymers removed?

There is no single procedure: it depends on which material it is, where it is, how much there is and how much healthy tissue is left around it.

One very widespread misunderstanding is worth clearing up first: aspiration rarely manages to evacuate the material. Biopolymers are not in a pocket that a cannula can empty; they are infiltrated between the tissues and surrounded by fibrosis, so the cannula simply does not reach them. And there is worse: the manoeuvre can spread the product into planes where it was not before. Save for very specific exceptions, it is not a route to treatment.

What does work is direct surgical excision of the material together with the inflammatory tissue around it, taking it out en bloc wherever the anatomy allows. This is usually done in a single operation. Only in very extensive cases, or where the skin is so compromised that removing everything at once would put its blood supply at risk, is the work staged over several operations.

The published literature points the same way: the main difficulty is the dispersal of the material between the tissue planes, and incomplete excision is associated with persistent inflammation and the return of the granulomas.

Can they be dissolved or removed without surgery?

No. This is one of the commonest and most dangerous misunderstandings.

Hyaluronidase, which does dissolve hyaluronic acid, has no effect at all on biopolymers: they are chemically different materials. Nor are they removed by massage, radiofrequency, drainage or any aesthetic treatment.

Be wary of any offer to “remove biopolymers without surgery”: it does not exist, and at best it means losing time and money.

What happens if I do not have them removed?

Not everyone develops complications, and some people live with the material without symptoms for a long time. But the material is still there and the risk lasts a lifetime.

The decision is not automatic: we weigh the amount, the location, the current symptoms, the state of the tissues and the risk of the removal surgery itself, which is not small. In some cases the right course is to watch and wait; in others, to operate even without severe symptoms, because the area is deteriorating.

What is not a reasonable option is to ignore it. Clinical and imaging follow-up lets you decide on evidence rather than out of fear.

Can the area be reconstructed after removal?

Yes, and it is part of the treatment, not an extra. Removing the material and the damaged tissue often leaves a defect in volume and shape that has to be dealt with.

Depending on the case we use autologous fat grafting — often over several sessions — flaps of the patient’s own tissue, or removal of excess skin to redistribute what is left.

Reconstruction is almost never done in the same operation as the removal: the tissues need time to settle and stabilise before anything can safely be built on them.

In which areas can they be removed?

The areas usually treated are the buttocks and hips — the commonest and the ones with the largest volumes — and the breasts. There the problem is the amount injected and how far it has spread between the planes, and excision, while demanding, is feasible.

In the face the answer is different, and we would rather say it plainly: in the cheekbones, the nasolabial folds and the periorbital area we do not advise removing the material. Nerve branches run through there, the product infiltrates between planes with no capsule to contain it, and fibrosis makes dissection difficult, so the risk of nerve injury is high and the result can end up worse than the starting point. Facial nerve injuries have been described during the excision of filler granulomas, and the literature warns that incomplete removal in the face can be more disfiguring than the original problem.

That does not mean doing nothing. In the face, management is usually medical and conservative — treating the inflammatory flare-ups and keeping the patient under review — and surgery is reserved for well-defined lesions, such as some in the lips, or for complications that leave no alternative.

In every case the approach is planned with imaging beforehand, so that we know what is there and where before we start.

And if there is a complication or I need a revision? Who covers it?

Every case is looked at individually, but the general principle is clear. If a medical complication arises, treating it normally involves only the cost of materials and theatre, so the cost is very small compared with a standard operation: the surgery is not charged for again.

As for minor refinement procedures, they are usually included, at minimal cost.

This is not a guarantee of outcome — medicine is an obligation of means, not of results — but an undertaking that, if something requires a second operation, we will make that as straightforward as we possibly can so that any problem can be dealt with.

Sources

The clinical statements on this page are based on the following sources, accessed on 1 August 2026:

• Dispersal of the material between the tissue planes and the consequences of incomplete excision: Surgical Management of Severe Bilateral Breast Silicone Granulomatosis.
• The impossibility of complete removal and the risk of greater disfigurement in the face: Silicone Granulomas, a Growing Problem?.
• Difficulty of dissection because of fibrosis, and facial nerve injury during the excision of filler granulomas: Complicated Facial Fillers: Management Algorithm.
• Late complications of polyalkylimide (Bio-Alcamid), case series: Complications of polyalkylimide 4% injections: a report of 18 cases.
• Delayed adverse effects and long-term follow-up: Delayed immune-mediated adverse effects of polyalkylimide dermal fillers.
• Migration of the material and outcomes of surgical removal: Long-term outcomes of surgically removed migrated polyalkylimide filler.
• Chronic granulomatous reaction and hypercalcaemia associated with permanent synthetic fillers: Biopolymers: Histopathologic Case Series of Patients with Permanent Synthetic Fillers.