Silikon 1000 Expert in the Raleigh/Durham Area?

Silikon 1000 is sterile silicone oil (purified polydimethylsiloxane) manufactured by a Swiss company called Alcon, Inc. The product was developed for use by ophthalmologists to treat retinal detachment and is FDA-approved for that indication only. Subcutaneous injection of silicone oil for facial soft tissue augmentation is an off-label (non-FDA-approved) use, and remains controversial. Silicone granules are treated by the body as numerous, miniscule foreign objects and in many patients can elicit a chronic inflammatory response and granuloma (cyst) formation. Subcutaneous injection of silicone oil can also be complicated by acute and/or chronic infection as well as migration of the silicone particles. Infections may be difficult to treat as the silicone material, once injected subcutaneously, cannot be removed.

Just to be clear, this is a very different material than what is used in contemporary silicone gel breast implants. Cohesive silicone gel implants are filled with silicone gel that is in a solid state, and which is contained by a solid silicone elastomer shell. Silicone oil, on the other hand, is a viscous liquid, which in fact is used as an industrial lubricant. Think hard about whether you want this kind of material injected into the subcutaneous tissues of your face. It's the only face you've got.

Silicone material injected into the subcutaneous space may look fine in terms of soft tissue enhancement for week, months or even years, and then begin to manifest some of these unpleasant and difficult to treat problems at a later date. It never goes away, so the recipient is potentially at risk for these complications for the rest of their life. I personally could not in good conscience inject this material into anyone's face. I have evaluated patients with silicone granulomas (cysts) and/or chronic infection that developed over five years after subcutaneous injection, and there are reports of these complications appearing over 10 years following injection. I am certain that there are some patients who never manifest any of these problems, but why roll the dice?

In the 21st century, patients seeking permanent facial soft tissue enhancement have the luxury of choosing a naturally occurring, non-toxic, safe, effective, and extremely well-tolerated filler: their own fat. Structural fat grafting is the process of harvesting fat from the trunk and/or thighs and transferring it to facial sites that require volume enhancement. It has no limitations anatomically - one can beautifully, naturally and permanently fill the temples, peri-orbital (eye) area, cheeks, lips, nasolabial folds, marionette lines, jawline, etc. It does not incite an inflammatory response or immune response, and it will never be rejected by the body. Fat also contains stem cells, which are dynamic cells that have a remarkable capacity to repair human tissues. Many facial fat grafting patients tell me that the quality of their skin improves dramatically in the months following fat grafting, and many plastic surgeons who perform a great deal of fat grafting procedures believe that stem cells are responsible for this effect (myself included).

So if fatty soft tissue volume is what is missing (which is the primary process of facial aging), it makes perfect sense to replace it with fat. It doesn't make much sense to me to replace it with a material used as an industrial lubricant.

Fat grafting is also a reasonable option cost-wise compared to non-fat soft tissue fillers, but cost is not the primary issue here. Your face is priceless, and you should treat it that way when considering the risks and potential complications of any injectable filler. Particularly ones that are not FDA-approved for injection into the subcutaneous tissue of the face.