Dangers of Using Silicone Oil As Facial Filler?

Question

I keep getting different information about the use of PMS/Silicone Oil as a facial filler. Is modern use of it really that dangerous? I would like to know once and for all, because I have a small amount of volume-loss in my face. I am still under 30, so I understand why I was advised to use a filler like Restylane. I have had those fillers a couple of times and within the first few weeks I am very happy with the results. However, these fillers dissolve so fast, so I've been looking for something a little more permament.

	I am aware of the dangers of using permanent fillers such as Bio-Alcamid (they are thinking of forbidding the use of it in Europe too). Yet, when I read about PMS/ Silicone oil, I read so many different stories that I do not know what to believe. Is there a way that it can be safely used? And how big are the risks with modern PMS/Silicone use?

Raffy Karamanoukian, MD, FACS · Answer

Silicone is manufactured in a number of viscosities and has been advocated for medical use due to its hydrophobic and theoretically inert properties. Medical grade silicone has been used for decades as a permanent tissue filler for the lips and soft tissues of the face. In fact, decades ago, silicone injections were used in the breasts and buttocks.

	The dangers of silicone injectables arise from their unpredictable safety profiles. The rate of silicone induced inflammation and tissue reaction is highly variable and may pose a significant risk of deformity and nodularity in the future. Since the injectate is diffusely involved in the tissue, it is difficult to remove if medically indicated.

	I regularly consult on patients who have successfully undergone silicone fillers in other countries. Many of these patients are happy but an unfortunate percentage of these patients are extremely disfigured and deformed as a direct result of the silicone. Thus, the risk is far too great to advocate in an elective procedure.

Jeffrey J. Roth, MD, FACS · Answer

The face will lose soft tissue as we get older. That is why plastic surgeons are now placing fillers, (Juvederm, Restylane, Sculptra, Radiesse), in the face. Some will last a relatively long time. 
The idea of silicone in the face is not a new one. In the past, it has been the cause of problems later on. Silicone can move, and the facial tissues may change over time, but he silicone does not necessarily move with it.
For all of those reasons, few plastic surgeons have embraced this technique. Better to have something that will fade away when it comes to the face.
BTW,  It is illegal to inject silicone in Nevada. 
Hope this helps.

Carlos Alberto Ríos García, MD · Answer

Regards, 
Liquid silicone is unsafe, please do not use it ever. The autoimmune response could be triggered by this substance, if you look around on the Internet, you will find patients that have a lot of problems with this product. The use for lips and other areas is off label. The inicial use is for retine problems. 
The Biopolymers cause a severe inflammatory reaction that can cause permanent damage to the tissues, known as Iatrogenic Allogenosis and an Autoimmune Syndrome (A.S.I.A. Syndrome). The risk of having autoimmune diseases and deformities due to tissue damage is very high, then the use of any substance that is permanent is not advised, it also could migrate at the inicial injection suddenly, via retrograde arterial flow, at blood stream, that would be a catastrofic event. If dont, it could migrate to aroud tissuses. So, you have to use safe substances that are resorbable like hyaluronic acid, there are brands like Juvederm and Restylane that are safe, within the Juvederm family, it exists Juvederm Voluma, that has a durability of 2 years approximately.

Please remember to be aware, do not let any permanenrt filler to be injected into your face, breast, buttocks, calfs, genitalia, etc. The safest way to increase buttocks is through your own fat injections or through silicone implants.
I hope the information was usefull, have a nice day! Dr Carlos Alberto Ríos.

Raj S. Ambay, MD · Answer

Silicone injections in various parts of the body has been done quite frequently all over the country. The difficulty with silicone injections begins with the quality of the silicone itself. I have seen many cases where industrial grade silicone has been injected inside the human body. This can be a tremendous disaster. Problems can include infections, granulomas, cellulitis, and persistent skin infections, disfigurement and skin dimpling. It is very easy to have silicone injected, but very difficult to have it removed. The removal can frequently be very complex and involved lengthy surgery. Multiple operation is not uncommon. It is not uncommon to expect scars in locations that would otherwise be undesirable. If you do have silicone, or are having problem with silicone that was injected by a non-healthcare provider then you should certainly seek medical attention. Some solutions include IV antibiotics, oral antibiotics and surgery after the inflammation has subsided. Removing the silicone is not just a cosmetic issue but also an issue of better health. Depending on the type of silicone injected concerns with autoimmune diseases and infections are foremost. Taking medications such as ibuprofen or cortisone is only a temporary measure. The real solution is surgery. Not all plastic surgeons are willing to operate on patients who have had silicone injected in their body. Many of these cases are not covered by insurance because they were performed for cosmetic reasons. My recommendation to anyone that has had silicone injections and wishes to have it removed, is to seek a board certified plastic surgeon who is likely willing to do more than 1 operation as well as willing to do some of these operations in a hospital setting. I have had patients visit me for removal of silicone and the discussion to proceed is never an easy one.

Steven Wallach, MD · Answer

Silicone injections were popular in the 60's and 70's. However, the silicone that ws used was not medical grade, and there were alot of problems with it often many years down the road. Besides the permanence and potential for overfill, it also included infections, granulomas, and terrible scarring to name a few. More recently, some doctors have been using medical grade silicone off-label to iject into the face for similar reasons. The ASPS does not condone the use of this product. The longterm sequelae are unknown. Remember, if you are overinjected, it is permanent and can not be removed easily.

Dangers of Using Silicone Oil As Facial Filler?

Answers (5)

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