Silicone Granulomas : Options to treat lumps / overcorrection from medical grade Silikon 1000 microdroplets for acne scars?

Question

I've had silicone microdroplets injected to elevate acne scars and unfortunately have been faced with overcorrection in some spots, resulting in visible lumps. I've had some mixed results with kenalog injections, but the bumps always return after a couple of months. Can dermabrasion or ablating with a C02 laser flatten these bumps? Or would I be better off getting injections of kenalog / 5-FU indefinitely every few months?

Eric M. Joseph, MD · Answer

Many people with acne scarring have areas of depressed skin, and areas of raised skin. Sometimes the high areas may become more noticeable, or some scars may "doughnut". If dilute triamcinolone acetonide injections are not effective, light electrosurgery with a Hyfrecator may be considered for flattening raised areas permanently, with minimal inconvenience. Simple shave biopsies of the raised skin may be considered as well. Thank you. Dr Joseph.

Raffy Karamanoukian, MD, FACS · Answer

I am a national expert on silicone complications and have had experience in the safe removal of silicone from the face. You may need surgical excision. Best, Dr. Karamanoukian Los Angeles

Julia Ann Sullivan Miller, MD · Answer

Granulomas that result from silicone injection are very difficult to treat.  In our office, we try steroid injections as the first step.  If this method is not successful, we usually excise the area and perform a plastic surgery closure to minimize the scarring.  Make sure you see a doctor with experience in handling this type of problem.  Good Luck!

Jason Emer, MD · Answer

This is a very difficult thing to treat.  Most of the time I find myself subcising and doing kenalog with 5FU along with fractional nonablative laser or radiofrequency treatments.  If this doesnt do it, then surgical removal is the best option.  I suggest getting at least one of them biopsied and cultured.  Find someone who is an expert in treating this.  Typically that is someone who injects Silikon or a lot of fillers and uses lasers. Best, Dr. Emer.

Silicone Granulomas : Options to treat lumps / overcorrection from medical grade Silikon 1000 microdroplets for acne scars?

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Silicone Granulomas : Options to treat lumps / overcorrection from medical grade Silikon 1000 microdroplets for acne scars?

Answers (4)

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