Silicone injections for cosmetic enhancement of the thighs and buttocks to achieve a more desirable body shape have become a concerning trend, despite the associated health risks and potential for complications and its resolution representing an increasingly common challenge for plastic surgeons. Several surgical approaches have been described, from standard and ultrasound-assisted liposuction and lipofilling, dermolipectomy procedures, and reconstruction of the whole anatomical area through tissue expansión or pedicle flaps. This chapter explores the various surgical options available to address the complications resulting from silicone injections in the thighs and buttocks.