I'm really sorry you're dealing with all of this. What you're describing sounds incredibly painful and emotionally exhausting. The complications you're facing are unfortunately common in people who have had silicone injections in delicate areas like the lips and perioral region. From what you've described, it sounds like the material has migrated and caused the vermillion border to extend. Silicone tends to migrate over time, especially if it was injected improperly or in large amounts. It can spread beyond the normal lip boundary, stretching tissues unnaturally and altering anatomy. This suggests a combination of encapsulated silicone granulomas, inflammatory flare-ups, often made worse by movement or pressure. Dryness and incomplete lip seal comes from both the altered shape and weakened muscle control (likely due to trauma from silicone or surgeries disrupting the orbicularis muscle. Strange movement of philtrum and perioral area suggests potential fibrosis tethering the tissue or loss of muscular function and support, making the surrounding areas compensate when you try to move your lips. Unfortunately, when surgeons try to remove silicone without prior experience and a very precise approach, it can cause scarring, widening, asymmetry, and loss of tissue integrity. Especially when the vermillion border or muscle is disrupted. This is why it's extremely important to seek a Board-Certified plastic and reconstructive surgeon who specializes in silicone/biopolymer removal. 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 You’re not alone — many people have been through this, and there are paths forward. But it takes the right expertise and realistic expectations. The goal with any revision is not just to make your lips look better, but to restore function and normal feeling, which you deeply need right now. Best of luck on your silicone removal journey.