Got Silikon 1000 years ago. I want it out. Can I do it with a steroid or something else? I don't want lipo on my face (Photo)

Question

I got Silikon 1000 five years ago. The past year I notice one cheek is bigger & higher than the other. When I smile it actually makes wrinkles under my eyes on the side that's bigger. Can I get it dissolved with a steroid shot or something overtime? I don't want lipo for fear of dents on my face. Can Kenalog help? I live in Georgia. Please help. My cheeks were nice at first. I liked them. Don't understand how they became like this. I'm actually scard to smile sometimes because it looks strange.

J. Timothy Katzen, MD, FACS · Answer

Hello simoned2, and thank you for your question about removing Silikon 1000 and the concerns you’re experiencing.

The issues you describe—one cheek becoming larger and creating wrinkles under your eyes—are unfortunately common with permanent fillers like Silikon 1000. Silicone and other permanent fillers integrate into your tissues and trigger an immune response, leading to the formation of scar tissue and nodules. Over time, this scar tissue grows unpredictably, often making the injected area appear larger, harder, or uneven. Worse, silicone can migrate from the original injection site, creating lumps or deformities in adjacent areas, which are difficult to control or predict.

Steroids like Kenalog may help temporarily reduce inflammation or soften scar tissue, but they will not dissolve or remove the silicone. In fact, repeated steroid injections can lead to thinning of the skin, pigmentation changes, or worsening contour irregularities. Surgical removal is the only definitive way to address silicone-related complications.

To plan for removal, you will first need an MRI to accurately map where the silicone has migrated and how it is distributed in your tissues. This imaging is crucial to guide the surgeon and ensure the most thorough removal possible.

There are three main surgical techniques for silicone removal in the face:

Facelift incision: This is often the preferred method, especially for cheeks. The skin is lifted, allowing the surgeon to carefully access and remove the silicone and scar tissue. This approach provides excellent visibility and precision, reducing the risk of leaving residual product behind. Additionally, as a benefit, this technique offers a facelift result, tightening and rejuvenating the facial skin while concealing scars along natural contours.

Direct incision: This involves making an incision directly over the area where the silicone is located. While it provides direct access, it often leaves visible scars and is generally avoided for aesthetic reasons, especially on prominent areas like the cheeks.

Intraoral approach: This method uses incisions inside the mouth to access and remove the silicone. It avoids visible external scars but offers limited visibility and control, especially if the silicone has migrated or formed extensive scar tissue.

Unfortunately, there is no way to “dissolve” or remove silicone with non-surgical options like steroids. Liposuction is not appropriate for silicone removal, as it cannot distinguish between healthy tissue and the silicone-filled areas, often resulting in uneven contours or dents.

I strongly recommend consulting with a board-certified plastic surgeon experienced in silicone removal. With careful imaging and surgical planning, it is possible to improve the symmetry and appearance of your cheeks while minimizing further complications. I hope this helps clarify your situation and provides you with guidance on the next steps.

Sincerely,
J. Timothy Katzen, MD

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers can cause severe longterm complications including inflammation and nodule formulation. Although results are longer-lasting that Juvederm or Restylane, long-acting fillers should be avoided.  
Bellafill, Artefill, and PMMA are known to cause granulomas and permanent nodules with swelling. This is not the case for everyone. Silicone biopolymers can also cause similar chronic inflammatory conditions. 
In my practice, I specialize in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. 
Silicone biopolymers can also be removed from the body if there are signs of migration or inflammation. All of these filler-types should be removed as early as possible. 
Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Eric M. Joseph, MD · Answer

In our experience, a surgical attempt to remove Silikon1000 may be futile and result in irregularities. Silicone becomes densely adherent to your skin and facial soft tissues, surgical procedures should be left as a last resort. Consider consulting a specialist for a trial of dilute triamcinolone acetonide (Kenalog) injections - this may result in less cheek volume. Wishing you well. Dr Joseph

Jason Emer, MD · Answer

This can either be removed surgically or treated with diluted kenalog combined with 5FU. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Got Silikon 1000 years ago. I want it out. Can I do it with a steroid or something else? I don't want lipo on my face (Photo)

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