Is dissolving silicone lip filler risky and what is the rate of success?

Question

Hi, I had a lip filler (silicone) injected around 15 years ago, and I'd like to remove it because it no longer looks natural and has some lumps. I've heard that there are ways silicone can be dissolved, but I'm not sure how this works. Is this risky and what is the rate of success? Would my lips go the way they were before the filler?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about what to do with the silicone in your lips. If someone tells you there is something that dissolves silicone, please do not walk away--please run away.  They are lying.  Zero percent of silicone is dissolved with any type of injection.  There is nothing that dissolves silicone. Steroids and kenalog etc. do NOT dissolve silicone. These products ONLY decrease the scarring around the silicone. Therefore, there is no product on the planet that dissolves silicone. If doctors are injecting steroid, they are ONLY treating the scar tissue around the silicone and therefore, NOT treating the cause, namely the silicone.  Bottom line: your lip silicone MUST be removed. If you do not remove the silicone or just keep having steroid injections to “band-aide” the problem, but do not permanently fix your lips, you will just continue to have silicone lip problems. The scar tissue that forms around silicone eventually turns into a granuloma. In turn, these granulomas can turn into cancer. Therefore, I would highly recommend that your lip silicone be surgically removed. Avoid, physicians who suggest other forms of lip silicone treatment.  Lip silicone removal is accomplished through an incision in the lip.  Lip silicone and associated silicone lip scar tissue is surgically removed. Lip silicone removal is completed under IV sedation or general anesthesia and takes approximately 1 hour to perform. Plan on a 5 to 7 day recovery period.

In most cases, silicone, PMMA, and biopolymer injections and associated scar tissue must be removed as soon as possible.  Silicone and PMMA removal is no easy surgery, so please seek an experienced, board certified plastic surgeon with significant experience in removing silicone and PMMA from the lips.  I specialize in silicone and permanent filler removal.  I am a lead investigator and founder of the Silicone Removal Institute.  If you cannot find an experienced, silicone or permanent filler 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.)

Jeremy S. Nikfarjam, MD · Answer

Hi Real.self.123!

Thanks for reaching out — it's great that you're looking into this carefully. Based on what you’ve described, here’s a breakdown of what you should know - unlike hyaluronic acid fillers, silicone is permanent and non-biodegradable, which means it can't be dissolved with an enzyme like hyaluronidase. Any suggestion that silicone can be "dissolved" is likely misinformation. The only way to effectively remove it is through surgical excision. Here at my New York based practice, I've successfully treated hundreds of patients who were suffering with silicone injections not only to the lips, but various parts of the body as well. For silicone injected into the lips, especially if it's been there for 15+ years and causing lumps or unnatural contours, the most reliable approach is surgical excision which typically involves carefully removing silicone deposits (which may have migrated or formed granulomas), while preserving as much natural tissue as possible to maintain shape and function. These incisions are often performed through mucosal incisions (inside the lip) to minimize visible scarring. Most patients see a significant improvement in shape, symmetry, and comfort and feel they look more natural and regain mobility or softness that was lost due to the silicone. A perfect return to your “original” lips may not be possible, especially if the silicone caused tissue changes or scarring - but a much more natural and harmonious appearance is a realistic goal. Keep in mind, fat grafting to the lips can be done to correct any volume that was lost during the removal stage.

I am a board-certified plastic and reconstructive surgeon with a specialized focus on silicone and biopolymer removal. Over the years, I have dedicated my practice to safely addressing complications arising from these materials. Recognizing the unique challenges they pose, I developed a surgical excision process along with reconstruction. This approach is designed to ensure the most complete removal possible while minimizing risks and optimizing patient outcomes. I'd be happy to see you for a clinical evaluation whether it be via a complimentary virtual consultation or an in-office appointment to discuss your options.  (516) 279-2616

Best of luck on your silicone removal journey! We're here to help if you need us.

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

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have a 20 year plus experience with silicone oil.  In fact, I wrote the special article in the Journal of plastic surgery on silicone oil.  Small bumps and lumps are very responsive to steroid injections.  Sometimes you have to perform 2 or 3 over series of a couple months, however these are very effective.  It would be important for you to contact someone who has experience with silicone oil.  Best wishes to you.

Praful Ramineni, MD · Answer

Unfortunately, there is no way to dissolve silicone.  It would have to be surgically excised. Results would vary according to how the silicone has reacted with your soft tissues. It is not considered a risky procedure.

Luis Lopez Tallaj, MD · Answer

La diferencia entre rellenos dérmicos reales como el ácido hialurónico o la hidroxiapatita cálcica es que permanecen donde lo inyectamos y no se mueven, y se absorberán en un plazo no superior a 12 a 16 meses dependiendo del caso y la zona tratada. Los materiales aloplásticos como la silicona y el PMMA invaden las células atravesando su citoplasma y se integran con los tejidos más cercanos, además se migrar y provocar deformidades comprometiendo la microcirculación, una verdadera pesadilla. En algunos casos podemos eliminar parte del mismo, nunca todo, intentando recrear una normalidad temporal en los labios, y hasta en otras zonas del rostro con riesgo de deformidades severas. Es muy importante que antes de realizarte las inyecciones faciales cosméticas verifiques el médico elegido por usted y busque en google la marca del producto que le ofrece este profesional. Recientemente publicamos un documental en nuestro canal de youtube Lopeztallaj, Besos de plástico explicando todo lo relacionado con esas inyecciones ilegales para una verdadera prevención. Tiene subtítulos en inglés y portugués.

Johnny Chung, MD, FACS · Answer

Thank you for your question. Liquid silicone is and never was FDA approved for injection in the United States as a filler. Unfortunately there is nothing that can dissolve the liquid silicone. The liquid silicone may form small granulomas underneath the tissue. The small granulomas need to be physically removed or excised. Some physicians try injecting steroids into the granulomas to dissolve the scar tissue. But because the silicone was actually not removed the silicone fluid is still retained underneath the tissue. It will likely cause a new granulomas in the future.

Carlos Castaneda, MD · Answer

Unfortunately, silicone is not a substance than can be dissolved You may have read about dissolving hyaluronic acid which is achieved with hyaluronidase, an enzyme that can do this, but it only works with hyaluronic acid based fillers Your only option may be surgery

Is dissolving silicone lip filler risky and what is the rate of success?

Answers (8)

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