Is there anything else I can do for more help with the silicone in my lips? (Photo)

Question

I had a lip reduction in June to remove some of my lip silicone that I had injected years ago and it was making my top lip protrude over my bottom. I feel like the silicone also migrated to my philtrum or the tissue above my lip and under my nose. It's awful. The surgeon who removed my silicone said he can't go above my lip because of the scar. Please is there any doctors who can do this ? Or what can I do? It looks like a silicone filler mustache.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if there is anything else you can do to remove silicone from your upper lip and how to get rid of your silicone upper lip mustache. Thank you for including your pictures. Pictures help a lot when analyzing what needs to be done. In your case you need more silicone removed. I would suggest one of two things. You could undergo an incision from the corner of the mouth to the other corner of the mouth and further silicone and scar tissue will be directly removed. This should help significantly. If however, you are most concerned about the silicone in the upper portion of the lip, I would suggest that the incision be placed in the vermilion border. The vermilion border is the line between the pink part of your lip and the white part of your lip. The difficulty with this area is that it’s a highly visible scar. If you do not mind the scar this will be the best surgery for you. Later you could have the line tattooed. Many women do this for lip accentuation. I did not suggest liposuction to the lip for further removal. Thank you for your question regarding how to remove the silicone from your upper lip. Good luck.

I specialize in biopolymer and silicone removal and subsequent reconstruction.  Since removing biopolymer and silicone is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in removing silicone from the buttock.  Do your research.  Make sure they have performed at least 100 biopolymer and silicone removal surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, buttock silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Jeremy S. Nikfarjam, MD · Answer

Hi Loonie, and thank you for your question. As a board certified plastic and reconstructive surgeon who specializes in silicone/biopolymer removal, over the past several years, I have effectively treated many patients with silicone injections to the lips that migrated to the surrounding area(s). As part of my pre-operative work up, I require MRI imaging for all of my silicone patients to determine the extent in which the silicone has migrated/traveled to. From that point, I can create an individualized surgical plan to effectively remove the silicone from the areas of concern. I would recommend seeking a surgeon who specializes in silicone procedures and its removal to avoid any unnecessary (visible) incisions/scars.
I hope that this helps and I wish you all the best! If you’re interested in learning more or if you have any questions, please feel free to reach out to my team here to schedule a complimentary virtual or in-person consultation.

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Praful Ramineni, MD · Answer

Silicone commonly migrates (because it's a liquid). The silicone may be able to be removed with an intraoral incision to hide the scar.  Silicone removal is always incomplete, however debulking the area should show very noticeable improvement.  This may be better treated in the operating room for more precision in removal.

Is there anything else I can do for more help with the silicone in my lips? (Photo)

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