Are some cosmetic injections riskier than others?

As early as the turn of the 20th century, paraffin was used to provide volume to the face. To summarize the medical history, it was not a good idea to put wax in the face. In the 1940s and 50s silicone oil was used to augment the breasts. There were a lot of medical problems due to migration of silicone oil and laws were enacted that limited the practice. Yet silicone oil is still injected into the face and body today. In some cases, industrial silicone oil is injected by lay practitioners in non-medical settings in the United States and abroad.

In Southern California, I have seen a number of patients who were treated with silicone oil in Mexico or South America. Here in the United States, treatment with industrial grade silicone oil in the transgender community is known as “pumping.” The practice was recently in the news having caused the death of a 23-year old transgender male.

Medical grade silicone is available and is FDA approved for use in complex retinal detachment. A small number of physicians have elected to take this product and use it “off-label.” In small volumes, it is unlikely to be life threatening.

However, the material is unpredictable and impossible to remove. The scar tissue it stimulates tends to hang in the face while the surrounding untreated tissue sags around it creating bizarre and unfixable changes in the appearance. Enough said.