Liposuction to Remove Silicone Granuloma on the Face?

I recently developed Silicone granuloma's on my face after injections to fill acne scars in 2004.

A plastic surgeon wants to perform liposuction. Has there been successful treatment with removing the granulomas with this technique?

Doctor Answers 10

Liposuction to remove facial Silicone granuloma

I'm sorry that someone thought that filling facial defects with silicone would be a good idea. Unfortunately, injecting silicone will always result in granuloma formation. And the only way to completely remove them is by excision. Liposuction would not guarantee full removal of the material if it could be aspirated.

A more aggressive approach but cosmetically more appealing, depending on the location of the granuloma, would be to use a facelift incision and remove it this way. This would be challenging but if possible cosmetically better.

Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Liposuction would not be a solution in my proactice

Liposuction would not be my first choice. Liposuction would remove normal and abnormal tissue equally and there is no guarantee that a silicone granuloma would even come through a fine liposuction cannula. Direct excision of individual granulomas would be my recommendation. In our Santa Rosa plastic surgery practice, liposuction is limited to removing fat and we do not recommend it for removing silicone.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Liposuction for Silicone granuloma on the face

Since the 1940's, silicone injections have cursed multiple generation of both patients and plastic surgeons who have to deal with unmet expectations and challenging complications. (If you are interested, read the later work of Dr. Thomas Reese then in New York).

It takes a few years for the same silly silicone injection procedure to be re-discovered, be used on thousands, for the same complications to resurface again and for it to be abandoned for a few more years yet again, only seemingly to be re-discovered again...

Silicone injections ALWAYS cause an inflammatory reaction associated with intense SCARRING. When you hear the spin that silicone "causes collagen formation Bela-Bela-Bela" - It is a kinder gentler way to SPIN - say silicone causes irreversible scarring which may fill an area.

I spent a while in Taipei, Taiwan where my colleagues had WEEKLY "foreign body removal cases" (IE silicone injection scars) from various parts of the bodies of gullible and remorseful young ladies - injected there by lay injectors of silicone. NOT a pretty picture.

Since a scar cannot be suctioned, I do NOT think you would do well with suctioning of the granola (medical speak for an inflammatory lump of scar tissue). A surgical excision would be indicated but will leave a scar.

I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Treatment of granulomas

I’m not sure if results with this treatment have been reported, but be concerned at least theoretically, that the granlomas are walled off with collagen that your body produces. This “cements” the silicone in place and liposuction may not readily remove these granulomas. If there are significant collagen attachments that need to be “sucked” free to allow the granuloma to be removed, it is possible that there may be depressions in the skin, similar or worse than the acne scars you had, that will appear months after the liposuction. It might be worth to treat just one granuloma as a test and wait a few months before having the rest done.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Removing silicone granulomas with liposuction

True silicone granulomas would be very difficult to remove using liposuction. It could work but it is not the standard of care and may likely not treat the problem.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

I doubt this would work.

 If you have a silicone granuloma then the silicone was probably injected into the skin. Liposuction will not remove this, especially since there is likely an inflammation around the silicone. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Treatment of silicone granulomas on your face.

I would need to see a photo to comment on your concern. If your physician adhered to the micro-droplet injection technique, the amount of Silikon-1000 required to treat acne scarring is minute. A typical treatment to both cheeks with Silikon-1000 for acne scarring may require only 1/5 of a teaspoon (1cc) or less, so I don't see the usefulness of facial liposuction. If you can, you should show your concern to the physician that injected your scars.

Silicone bumps occur infrequently, and are easily treated with dilute triamcinolone injections (steroid), or sometimes light electrosurgery in an office setting.

Feel free to email me a photo of your concern, along with any other relevant information, and I would be happy to try to help you. It would be useful to know how many treatments you had, and how much silicone was injected.

I hope this is helpful.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Cortisone injections may be a much better option for silicone granulomas

Silicone granulomas respond to intralesional kenalog injections better than any other treatment except direct excisions. Try the injections first for a series of 5-8 sessions 2 weeks apart before going to excisions.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Silicone granulomas

Treating silicone granulomas are difficult at best.  Trying to liposuction these particles that can invade multiple layers of tissue is unlikely to be successful. You probably need direct excision of the granuloma.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Silicone granulomas

Silicone granulomas need to be surgical excised although liquid silicone might be partially suctions if truly free foating. This is a difficult problem and I would suspect that your granulomas are quite superficial if the silicone was used for acne scars. This would make liiposuction much more risky and probably less effective.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.