Permanence is largely the appeal of silicone injections over temporary hyaluronic-acid fillers, such as Juvéderm and Restylane, and poly-L-lactic acid–based Sculptra. But that quality can cause a host of problems.
Aesthetically speaking, silcone’s permanence does not equal longevity of results. “Its long-term behavior is unpredictable,” says Dr. Stephen Prendiville, a facial plastic surgeon in Fort Myers, Florida, in a RealSelf Q&A. Liquid silicone can spread and migrate throughout the body, beyond where it was injected, possibly leading to contour irregularity, dimpling, and nodules.
One RealSelf member, rkcndy, shared her story 14 years after getting microdroplet Silikon 1000 injections in her lips: “I knew about the possibility of the silicone doing a little migrating, but I did all kinds of mental gymnastics to tell myself that it wouldn't happen to me. As I've aged, it's not my lips themselves that have volume—it's the area slightly around my lip line. The material has migrated beneath the lower lip edge, and it just keeps getting worse. I look like I have a permanent fat lip.”
You’re lucky if the migration only leads to an undesirable aesthetic outcome. An FDA safety communication warns, “When injected into areas with many blood vessels, such as the buttocks, [silicone] can travel to other parts of the body and block blood vessels in the lungs, heart, or brain. This can result in permanent damage to those tissues and lead to stroke or death.”Â
Blocking a blood vessel is also a risk during nonsurgical nose jobs, and it’s the reason many plastic surgeons who perform them won’t use silicone.
Other complications include chronic pain, infection, inflammation, scarring, and permanent disfigurement. Some people develop granulomas, or lumps of inflamed tissue, that can interfere with nerve sensation, organ function, and muscle movement.
“Silicone material injected into the subcutaneous space may look fine in terms of soft-tissue enhancement, for weeks, months, or even years, and then begin to manifest some of these unpleasant and difficult-to-treat problems at a later date,” explains Dr. Michael Law, a plastic surgeon in Raleigh, North Carolina, in a RealSelf Q&A. “It never goes away, so the recipient is potentially at risk for these complications for the rest of their life.”Â
Because of the way it spreads, liquid silicone, including Silikon 1000, is extremely difficult to remove. “The removal can frequently be very complex and involve lengthy surgery. Multiple operations are not uncommon,” says Dr. Raj Ambay, a plastic surgeon in Wesley Chapel, Florida, in a RealSelf Q&A. Often, surrounding tissue must be removed to get all the silicone out, leading to disfigurement and scarring.
