Can silicone injections using the gradual microdroplet technique eventually fill a lip as well as the implants that are out there? I ask this due to not having success with two different lip implants.. One became infected and the second implant has deflated on one side. I really did like the fullness the implants gave me but have not had good long term success with them. Thank you
Silicone Lip Augmentation Injections Vs Implants.
Doctor Answers 13
Silikon-1000 may be used by experienced physicians for permanent, natural-looking lip augmentation. Video attached.
Silikon-1000 is a permanent, off-label filler, so your results, good or bad, are permanent. My experience with Silikon-1000 for permanent, natural-looking lip augmentation has been excellent. Several treatments (1-3) are typically necessary to obtain a desired result, and in my practice, problems are infrequent. Tell your doctor if you have a history of frequent cold-sores or herpes-infections on your lips: you may need to be pre-treated with valcyclovir (Valtrex).
You must find a reputable dermatologist or facial plastic surgeon experienced with the serial puncture, micro-droplet technique. You should also have a discussion with your doctor about the FDA's position with respect to using Silikon-1000 in an off-label fashion to enhance your lips. Lastly, you should see many before and after photos demonstrating beautiful results before you pick your doctor and proceed.
In my practice, Silikon-1000 is safe for permanent Lip Augmentation, and leads to completely natural-looking, smooth lips. In just about everyone, patient satisfaction is very high.
I've attached a link to an interview I did for the Lip Augmentation Forum here at RealSelf.
I hope this is helpful for you.
Regards from West Orange, NJ
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Permanent Lip Enhancement - Los Angeles
Hello and thank you for the question.
I would highly advise against having liquid silicone injected into the lips. The results can be extremely unpredictable, with the downside risk being product migration and subsequent lip deformation. This is extremely difficult to correct and, generally speaking, leaves the lips permanently deformed with only minimal to modest room for any significant improvement.
If you are interested in a permanent lip enhancement procedure, I would have you consider fat transfer, if you are a candidate. Patients tend to be very satisfied, the results are predictable, and there are no associated downside risks involved in comparison with those of liquid silicone injections.
Glenn Vallecillos, M.D., F.A.C.S.
Patience is key
Silicone droplets can give the same fullness over a period of time (and several injections). The silikon 1000 must be used cautiously and slowly. If injected by someone without experience (in too high a volume too quickly) permanent lumps can form; however, if you are willing to be patient and have an experienced doctor doing your injections the results are fantastic with no downtime, or unnecessary discomfort.
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Silicone in the lips or anywhere
While injection technique is important what happens under the skin once an agent is injected is far more critical. What you seek to avoid at all costs is an immunologic or allergic reaction to the implanted substance. Why? Such reactions can cause large lumps that at times can be so severe they can result in facial deformity. In regards to bovine collagen most allergic reactions can be avoided by 2 negative skin tests. I developed double testing to avoid most all immunologic consequences of collagen injection. To illustrate what I mean, imagine what happens if you had poison oak implanted under your skin. It would not be comfortable nor would the reaction be beautiful.
The popularity of this form of facial restoration also saw the approval of various injectable fillers and toxins by the FDA which should have never seen the light of day. Until recently, the effects of all injectable filling agents were temporary and very rarely associated with permanent problems. In the past, the permanent injectable silicone had been used but had been so problematic that the Justice Department filed injunctions against certain physicians on behalf of the FDA. After 2000 a dangerous pattern grew in the corridors of Washington, D.C., where politics and money changed the face of America and the field of aesthetics to the detriment of the faces of the consumers.
Industry has accomplished the approval of synthetic agents which should have never reached the market. Once injected under skin the body cannot digest these agents and the immune system walls them off with resultant formation of nodules, which at times require surgical removal. One such product that was approved was Artefill® or Artecoll®. This product is polymethylmethacrylate or which is injectable Plexiglas beads. This product has long been associated in the worldwide dermatologic literature with scarring, and disfigurement only amenable to correction by surgery. At present, Artecoll®, the predecessor of Artefill®, is no longer available in Europe or Canada. In 2003, the American Society of Dermatologic Surgery newsletter 'Currents" promoted the use of Artefill® to fellow dermatologists. Physicians in this Newsletter encouraged and promoted the use of this agent. It was later revealed that at least one of these physicians had been given a large amount of stock (35,000 shares) by the manufacturer, which was not publicly revealed.
We knew from the experience of Artecoll® in Canada that pharmaceutical companies cannot be relied upon to report adverse events to authorities, yet the FDA claims that it can evaluate adverse reactions by relying on doctors and "Big Pharma" to report these directly to the FDA. Furthermore, merely changing the name of the product (e.g. Artecoll® to Artefill®) doesn't change the history or adverse experiences of the past. In the literature, consultants have used the names interchangeably. Furthermore, if Artefill® is new and improved, how can one gain FDA approval of Artefill® by studying Artecoll®?
In 2003 The "Currents" newsletter of the American Society of Dermatologic Surgery established an expert panel on fillers from which I was excluded. This was odd as I was the filler editor of the Journal of Dermatologic Surgery as well as the recognized world authority on fillers. Could the reason be that I had lectured prior to this newsletter on the problems with Plexiglas fillers? It was well known to me that Artefill®/Artecoll® (Artes-Medical, San Diego, CA) caused severe adverse reactions which frequently required surgical removal of the product. It was later revealed that Artes founder Dr. Gottfried Lemperle, a plastic surgeon, improperly injected 10 people in the United States with some form of the company's wrinkle-filler before it was approved for market by the FDA. Subsequently, Gottfried Lemperle resigned as the company's chief scientific officer and a director but was retained by the company briefly as a consultant.
Both Gottfried and his son were cited in a lawsuit filed by Hairdresser Elizabeth Sandor, 40, who alleged in May 2006 that Dr. Lemperle used Artefill® as an injection to fill her facial wrinkles in 2002. She alleges that Lemperle falsely convinced her that Artefill® had received FDA approval, and that he never disclosed his lack of license in California. Her claims detail suffering of pain and disfigurement she attributed to a reaction to Artefill. Sandor's face was inflamed, she had scarring near the injection sites and had a fever and aches and pains. Prior to approval by the FDA there were European reports of a significant incidence of large lumps 3-4 years post implantation. Furthermore both Germany and Switzerland had already advised physicians not to use this product.
The purpose of the FDA is to protect the public interest in safety and efficacy of all medical products. Prior to the release of Artefill® in the USA, I contacted a senior member of the FDA with articles regarding the foreign experience with Artecoll but this did not prevent release of this product. Subsequently an article which quoted me in the Wall Street Journal revealing the seriousness of adverse reactions to Artefill® helped cause the parent company to go into bankruptcy but I have recently seen a company trying to bring this product back to market. Why would a company attempt to bring back a filler that has so many medical issues and how can the FDA let this happen?
The physicians supported by "Big Pharma" are the very same people who run medical societies, edit and advise trade publications, appear on the internet, television, and speak before the FDA. These physicians are responsible for the recent FDA approval of permanent injectable agents as well as other synthetic products or semi-permanent agents that are placed under the skin. These products have gained approval because these paid physicians ensure that the products are marketed to doctors reading the trade journals and through communications from their medical societies. These products fill the communication highways of the medical community despite a total lack of information and scientific data concerning their behavior once injected under the skin. Some of these agents have had a disastrous history abroad, but the FDA aesthetic device panel showed disinterest in these studies. Since when does the FDA not pay attention to controlled studies? The answer is simple, when their results are not agreement what the industry is supporting.
The lead physicians appearing before the FDA supporting many of these agents were foreign and not licensed in the U.S. Furthermore, on at least one occasion the physician's significant financial interest in one of these companies was not disclosed. Often times the studies they performed were done outside this country and of questionable validity yet the FDA was most accepting of this data. I feel it is critical these studies be done in the USA.
Throughout the time I was attempting to awaken the FDA to the problems with Artefill® I attempted to reach Stephen P. Rhodes, a pivotal individual who works closely with the Cosmetic Device Panel of the FDA. He had been working closely with Artes but only contacted me after my article was published in the Wall street Journal about the severe problems with Artefill®. In response to my article; a public hearing was held in November 2008 at the FDA regarding problems with injectables. The meeting was led by an oncologic surgeon and invited spokesmen were plastic surgeons with a poor understanding of the art and science of injectables. I spoke to the oncologic surgeon and he promised me I would be given sufficient time to speak.nI traveled 3000 miles yet at the meeting was not allowed to speak to panel members and was given 4 minutes to review my 30 years experience with fillers. At the hearing they evaluated all fillers as a single group which prevented a thorough evaluation of each injectable. As a result only the most frequently used injectables received warnings. What I took away from that meeting was the realization that freedom of speech had all but been extinguished at the FDA. They was far more interested in protecting the manufacturers than the patients. In this the patients would better described as victims! The filler Sculptra®, or New-Fill™, was at one time considered an important agent in managing facial fat loss in HIV+ patients. Prior to FDA approval, it was used in a clandestine manner. In clinical trials evaluating this agent for correction of fat loss in HIV+ patients although the study patients were for the most part satisfied, up to 50% of the injected individuals developed some degree of lumpiness in the treated areas. Furthermore, these lumps are often far from invisible. Nevertheless, Sculptra® received rapid track compassionate release approval from the FDA for use in patients with HIV. The panelists on the General and Plastic Surgery Device panel were strongly unanimous in limiting approval only for patients with HIV. At the FDA hearing, not one histologic slide showing the fate of Sculptra upon implantation was shown. Again, how can an agent gain approval without scientific data supporting its application? According to the European literature the consequences of Sculptra® in the normal host has been very problematic (foreign body granulomas, infections, etc.)
Frequently the only way to get rid of these lumpy ridges is to excise (cut out) them from the face.
Nevertheless, the lay press, medical conferences and internet began to promote this substance for soft tissue augmentation in HIV negative patients. Although prospective studies for the use of this agent in individuals with normal immune functioning had not yet been completed in the United States, we did have reports of the European experience.
In 2000, at the World Congress of Dermatology in Paris, Pierre Andre reported cystic, nodular, and granulomatous lesions when this agent was used in individuals with normal immune functioning (non-HIV+ patients). Additionally, long-term allergic reactions have since been described, which are very difficult to manage. In another report concerning its aesthetic use in 100 patients with normal immune functioning, 20% of the treated individuals experienced significant adverse reactions. Obviously, this product is not immunologically inert as the manufacturer stated. Foreign body granulomas are being seen with this agent in HIV-positive as well as immunocompetent patients.
While the manufacturer as well as investigators claim this product produces neocollagenesis or new collagen this is not what is seen under the microscope. On biopsy one sees a severe immune reaction to the product.
Another product, Radiesse® (BioForm Medical, San Mateo, Calif.) is an injectable filler material composed of synthetic calcium hydroxylapatite microspheres (30 percent) suspended in an aqueous carrier gel (70 percent). At present, Radiesse® is indicated in the United States for correction of moderate to deep nasolabial folds and for correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. Its off-label use in other facial aesthetic indications is widely reported in the literature. While a precise injection technique will supposedly minimize potential effects such as nodule formation and helped avoid persistent overcorrection, livid coloring, and asymmetry, the variation in injection techniques is immense. I personally have seen lumps in the cheeks, tear troughs and lips after Radiesse® use. Some of these lumps were over 2 years duration.
It is a strange time. Everyone wants to publish in the realm of minimally invasive aesthetics. Filler experts are everywhere and yet most fail to report adverse reactions to agents to which they are consultants. As a physician one must remember "everything that is obsolete was once new, which indicates that everything that is new is not necessarily better." Recently consultants have tried to blame bacterial colonization on the filler for adverse reactions. This is negated by what is found when filler problems are viewed under the microscope.
One would assume that the problems of these adverse reactions would be the topic of medical meetings and conventions. These meetings were at one time places where physicians eagerly shared their medical advancements and warned of adverse reactions. The hotels were moderate but ideas were intellectually exciting.
In 2011 medical meetings have become nothing more than trade shows where drug companies discuss and demonstrate their latest wares. The meetings are often held in grand resorts at distant foreign locales. Additionally, much of the medical literature itself has evolved into nothing more than promotional material of questionable accuracy also underwritten by Big Pharma. Presently even continuing medical education (CME) in the USA is no longer a science but a business where the manufacturers of these products promote the use of filler products and even teach off label use (using the product outside of what the FDA has approved it for) without regard for informing doctors of adverse reactions. The manufacturers underwrite the costs of these large conventions and CME courses to the tune of a billion dollars annually. In the world of facial Aesthetics especially this behavior is rampant.
When it becomes your time to fill; do some research beforehand. It could save you pain, expense and ultimately your face. Also find out what is in the needle before the needle goes into your skin.
Furthermore, it is time to keep Industry out of medical education, and prevent them from turning the medical literature into written advertisements. Most importantly you must keep industry away from your face!
Permanent Fillers versus Lip Implants for Lip Augmentation
IMHO, silicone injections to the lips should never be done. The list of potential complications is long and well established. You can't predict what the silicone will do for the rest of your life. From what you describe, one of the lip implants is the gortex coated saline filled lip implant....I've never been a fan of that particular lip implant as gortex seems to get infected years after placed inside tissue and saline filled implants in the lips seem like they would be prone to rupture.
If the other lip implant was the solid silicone implant, you might want to try Alloderm, which I have used for over 15 years with very good lip augmentation results. It's soft, supple and lasts for 7 years giving more filling effect than any lip fillers...aside from silicone that's just not worth the risk again, IMHO.
Do not have silicone injected into your lips. There are so many better and safer alternative. The HA fillers work like a charm although they require reinjection every 6 months to a year. Fat transfer is also an alternative. I would never inject silicone into someones lips and would run the other way from anyone suggesting it.
Permanent lip implants
Permanent lip fillers like silicone have the risk of permanent side effects. These include bumps that can appear many years after the injections called granulomas. As you age, you may not want as full a lip as you desire now. I recommend hyaluronic acid fillers for the lips. They feel and look natural, and with repeated treatments can last a year or more, though initially they generally last 6 months.
Liquid silicone does not belong in the body. Do not place it in your lips. There is a great solid silicone lip implant available at your plastic surgeon's office. It's called PERMA Facial Implant. That will give a very natural lip enhancement.
Silicone injections not recommended for lip enlargement
Silicone injections for lip enlargement is an off-label usage which I would not recommend using. (Off label means not approved by the Federal Drug Administration for that particular usage). The effects are relatively permanent and can be quite problematic particularly if there are problems which are not rare. There are many other options available that at least are reversible or correctable particularly with time such as the hyaluronic acids and even fat.
Lip injections and lip implants
I am sorry to hear that you have not had success with two different types of lip implants. I am not sure what implants in particular you have tried, but I have had great success with a soft solid silicone rubber implant called PermaLip. These have worked well and provide safe and natural results. The nice thing is that they stay in place, are not subject to injector mistakes, and can safely be removed for any reason.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.