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.
