Through the years, various substances have been used for body contour; however, in many cases, these are illegal fillers applied by nonhealth professionals. After the application of these materials, the patients experience an important immune response, causing local, regional, or systemic complications, such as ASIA syndrome. As these materials are unapproved, the timing of appearance of the complications is unknown. The skin changes: granuloma formation, atrophy, ulcers, infection, and necrosis, are associated with great deformity. The surgical management depends on the characteristics of the lesion, but the main objective is the quasi-complete removal of the material applied to avoid recurrence of the symptoms. The in-block excision with reconstruction is the best approach. The reconstruction depends on the extension of the defect; our workhorse flaps are the anterolateral thigh flap (ALT) or the deep inferior epigastric perforator (DIEP) for skin replacement in cases with skin infiltration.