Persistent swelling, no improvement 4 weeks after removal of silicone granuloma due to silicone migration - normal? (Photo)

Hello, I am sorry you had silicone injected into your lips and that now you are having problems. Also, I am sorry that you are having swelling after your lip silicone removal surgery. I am sure you know that silicone is a PERMANENT filler. Because silicone is a PERMANENT filler, silicone will NEVER go away without surgical intervention. Given your current situation, I would WAIT another 4 to 6 weeks for you lip to "heal". Then, I would HIGHLY suggest revision lip silicone removal surgery. I believe you have more silicone still left in your lip. I specialize in lip biopolymer and silicone removal and subsequent reconstruction with lip fat grafting and/or implants. I am the lead investigator and founder of the Silicone Removal Institute. Since removing lip silicone is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing your lip silicone. Do your research. Make sure they have performed many lip 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, silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, 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.)

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