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Can silicone injections be removed from the face?

Q:

I've had silicone injected into the cheek area of my face but it has moved down to the mid section of the face.  Is it possible to remove this?

A:

The removal of liquid silicone after silicone injections is very difficult and fraught with potential complications.

It is not as commonly seen in the United States for many years.  Now It is occasionally seen in patients who have had the injections done in Asia.

Some of these injections can be treated by suctioning out pockets of silicone liquid to reduce the amount of silicone, or by excision of tissues filled with injected silicone, but it is impossible to remove all of the silicone. 

Unfortunately, scarring and deformities are common after silicone removal procedures, and presently there is no good solution available.

Fredrick A. Valauri, M.D.
New York, NY

A:

If your migrated silicone remains in blobs rather than drops, you could attempt suction assisted removal using liposuction technology.  Imaging studies may help determine the volume of your collections such as ultrasound.  Regardless, you do have a challenging issue and as mentioned before, it would be near impossible to remove all of the silicone.  Best wishes in finding a solution to your problem.

A:

The removal of injected liquid silicone from the face, or elsewhere in the body, is difficult and very challenging.  Large accumulations or pools of the material may be partially removed or reduced by aspiration or liposuction.  If the liquid has migrated or is dispersed into small droplets or particles spread over a relatively large area or volume of the face, its complete removal is much more difficult, if not impossible without causing significant deformity.  In such situations, excision of the tissues that have been infiltrated with the material is necessary.  Such procedures are often performed selectively, only to remove those tissues where scar has built up around the silicone or where infected or chronically inflamed cysts have formed.  Because of the structure and nature of the face, removal of even small amounts of tissue can have a very significant and adverse effect on appearance. Often more than one operation is necessary as are reconstructive procedures to improve the resulting deformities.  For these reasons, the injection of liquid silicone is very controversial and should only be undertaken with great caution.  I suggest you seek the help of an experienced plastic surgeon, certified by the American Board of Plastic Surgery.   

 

A:

Silicone injections in the US is an underground practice that is practiced by unresponsive people who are not Doctors to begin with. The silicone used is not a medical grade silicone. (They buy this silicone from the hardware store (Caulking silicone). This is a fact that I have encountered numerous times in my practice. Silicone is being injected to the face, breast, buttocks, arms, and have seen one injected to the neck. If one is fortunate and not developed severe infection then the ultimate result is the formation of very hard lumps called GRANULOMAS. These granulomas are so hard they can not be liposuctioned, even Ultrasound liposuction will not effect them, you can not even cy them with a sharp MAYO scissors.

In the face they intertwine with branches of the facial nerve and is impossible to remove.  In my experience in the face you can remove what you think is safe to remove and reposition the rest that has dropped down.

In general injection of the area of granulomas with cortisone will make it less reactive and less hard and may facilitate the removal. However cortisone injection runs the risk of dissolving the surrounding fat.

Most of these patients have spread of silicone into the surrounding tissue and to local lymph nodes group. Invariably any attempt to remove the silicone granulomas will result in major deformities that will require some reconstructive procedure that insurance WILL not cover. Multiple procedures are required.

Harmonic scalpel is an instrument that I found to make the removal of the granulomas a little easier than the bovie, knife or scissors.

Also HYDRGELL has been common material for underground injection to buttocks. The body reaction is the same as silicone major granulomas, with the same difficulty in removal.

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