What are my options to remove silicone in lips? (Photo)

Question

I had silicone injections in my upper lip done in 2016. As you can see, my lip looks totally off. I knew what I was doing was wrong, however I gad zero clue as to the deformities it would cause. I had cortisone injections several times, but it only provides temporary results for the swelling. What are my options for dealing with this problem?

Jeremy S. Nikfarjam, MD · Answer

Thank you for being open about your experience—this is unfortunately a more common situation than many people realize, and it's important that you're seeking help now. Before proceeding with treatment, the first step is usually an in-depth clinical evaluation, often supported by imaging such as MRI. This helps determine how much silicone is present, whether it has migrated, if there is associated fibrosis or granuloma formation and the depth and distribution (superficial vs deep plane). If the silicone is causing persistent deformity, asymmetry, or chronic inflammation, surgical removal is the most definitive option. This typically involves a direct excision through intraoral or external approaches, depending on the location and extent. Once removal is complete, reconstructive techniques to preserve or restore lip shape. This includes autologous fat grafting from a separate donor site to the lips to restore structural integrity and functional mobility. Non-surgical management may include dermal filler augmentation to restore lip, contour and correct minor asymmetry or divots following the initial excision. Please note - the surgical option is permanent and non-surgical is not and would need to be maintained every 6-12 months. Given your history and description, you may benefit from surgical removal and reconstruction by a plastic surgeon experienced in silicone excision and lip reshaping.

I am a board-certified plastic and reconstructive surgeon with a specialized focus on silicone and biopolymer removal. Over the years, I have dedicated my practice to safely addressing complications arising from these materials. Recognizing the unique challenges they pose, I developed a removal and reconstruction technique that is designed to ensure the most complete removal possible while minimizing risks and optimizing patient outcomes. I'd be happy to see you for a clinical evaluation whether it be complimentary virtual consultation or an in-office appointment to discuss your options.   (516) 279-2616

J. Timothy Katzen, MD, FACS · Answer

Hello Eclectic228947,

Thank you for your question regarding the removal of silicone injections from your upper lip. I understand your concerns, especially with the visible deformities and the previous temporary results from cortisone injections.

Surgical removal is indeed your best option for a permanent solution. The procedure typically involves making a small incision directly under the area where the silicone is located within your lip. This approach allows for the precise extraction of both the silicone and any associated scar tissue. Given the localized nature of your situation, this can often be performed in an office setting under local anesthesia, minimizing downtime and simplifying recovery.

For cases where silicone has been injected more extensively or involves both the upper and lower lips, a more comprehensive surgical approach under general anesthesia may be necessary. This would involve more extensive incisions and a longer recovery period, but it's essential for achieving optimal results and preventing further complications.

Post-surgery, you can expect to have dissolving stitches which typically resolve within about 10 days. Most patients find they can return to their normal activities within 1-2 days, though swelling and some discomfort may persist for a short period.

It's crucial to have this procedure done by a skilled plastic surgeon who specializes in the removal of silicone injections, as the success of the outcome greatly depends on their expertise. I recommend consulting with a board-certified plastic surgeon who has experience with similar cases to discuss the best surgical approach for your specific condition.

Good luck. I hope this provides a clear path forward for addressing your concerns about the silicone in your lips.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers are commonly used in the face and body. They may sometimes cause noticeable symptoms that we gauge using the Karamanoukian Soft Tissue Reaction Grading Scale from I to V. The severity of your complications dictates the interventions needed, ranging from itching and burning to severe necrosis of the soft tissue. Nerve pain and symptomatic swelling is also possible. Insurance may cover your surgery, but that is a discussion that requires you to contact and appeal to your insurance carrier. Options for removal are complex and depend on whether you have the material in your face or body. We reverse BBL with silicone commonly and remove silicone from the lips very commonly. Diffuse silicone in the face is not likely to respond to removal. Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. We can also test for the material to determine the likelihood of silicone granulomas and silicone reaction.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

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