Currently, liquid silicone is used off label as an ophthalmologic adhesive agent, specifically for those with retinal detachments. Silicone injections to the face have a long history. Like any aesthetic tool, in the right hands, it can result in a happy patient with a long term aesthetic result. Liquid silicone works by becoming encapsulated in scar tissue leading to a permanent augmentation. At face value this sounds compelling. Who wouldn’t want permanent augmentation?
There are two potential issues with liquid silicone. First, is its’ purity. Many practitioners use low grade silicone in lieu of the FDA approved ophthalmologic silicone. Second, and most importantly, as facial structures surrounding the areas of silicone injections undergo their normal atrophy, the areas injected with silicone become disproportionally large and unnatural looking. Since silicone in general is not a reversible procedure, you can become permanently distorted.
The liquid silicone beads encased in scar become extensively intertwined with the subcutaneous tissues. In the lip this would be the lip muscle where the silicone not only makes the lips larger but influences how they move when you speak or smile. Removing silicone from the lips is difficult at best. Any surgical intervention to remove the silicone also removes muscle tissue and leaves a trail of post operative scarring in its place. The recovery from this surgery can be painfully long with profound swelling continuing for months. Some physicians use steroid injections to soften the scar but the result is rarely a normal size or aesthetically shaped supple lip.
Procedure Snapshot:
Part(s) of the body treated by this method: lips
Time for procedure:15 minutes
Adjunct procedures that may be considered: intra-lesional steroid injections and lip lift
Anesthetic: local
Number of sessions required: 3-4
Downtime: none
Complications/Risks: minimal
How long results last: should be long term stable result
Cost $/$$/$$$: $$
One on one with Dr. Kornstein:
Correcting silicone injected lips is both a reconstructive and aesthetic endeavor. Obviously the best solution is to avoid any permanent fillers in the face however for some patients, that decision has already been made. Until now there have been few options for those wanting to reverse the aesthetic damage done with silicone. The good news is that today there is an answer.
I recently treated a young woman (pictured above) with silicone lip deformity using Ulthera and have been successful in reducing lip volume including the unnatural anterior projections with no downtime typically associated with surgery. Ultrasound therapy—the hallmark of Ulthera—heats collagen and creates micro thermal “burns.” This gentle heating reduces and softens the scar volume so as lips move the scar becomes more linear and less bulky. Using a dental block eliminates any discomfort during the procedure. Ulthera ultimately influences the shape of the collagen resulting in the scar tissue becoming malleable and eventually adopting a more functional shape. The presumed mechanism is a remodeling and contraction of the scar tissue associated with the silicone beads. Think of a potter with a clay pot. While the clay is still wet, it can take a different shape depending upon the potters hands. Similarly, Ulthera reverses the “hardening of the clay” formerly present in the lips. As the mouth moves, the effects of Ulthera essentially help reshape the lips. Several sessions are necessary, but lips show an improvement immediately with more positive changes evident at 2 weeks and beyond. Apart from discovering Ulthera to be a cosmetically viable option, by far the biggest advantage is dodging the post operative trauma associated with surgical “correction.”
One of the most frequent concerns expressed by my patients on a virtually daily basis is that their facial surgery will result in a natural aesthetic, one that makes one see themselves in the mirror and not a stranger. I take great pride in having the ability to reverse undesired outcomes; giving patients the opportunity to regain the “identity” they thought was lost.
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