What is the Reason for Hard Lumps After I Had Lip Reduction to Take out Some Injected Silicon?

Question

upper lip riduction, i had soft lumps. after the procedure i have really hard lump. i would like to know the reason for that (fibrosis?), and what is the best non invasive solution (steroidor 5FU injections for along time?)

Jeremy S. Nikfarjam, MD · Answer

Thank you for your question. This is a very important topic, and unfortunately there is a lot of misinformation out there.

Silicone injections (especially older, free silicone) behave very differently from normal fat. Over time, the material can migrate and become intertwined with your natural tissues, often leading to inflammation, scar tissue, and granuloma formation. Because of this, there is no reliable evidence that any form of liposuction, including “Smart Lipo," that can effectively or safely remove silicone.

In fact, liposuction in these cases is generally not recommended and can actually make things worse by spreading the silicone further into surrounding tissues, increasing inflammation or scarring and/or
creating contour irregularities or worsening deformities

A proper evaluation is essential before considering treatment. In our practice, we typically begin with advanced imaging, such as an MRI, to determine where the silicone is located and how extensively it involves the surrounding structures. This helps guide a more precise and safer treatment plan.

Treatment options vary depending on the area and severity but may include carefully planned surgical removal, often performed in a targeted and conservative manner to minimize additional damage.

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 removal and reconstruction technique that is designed to ensure the most removal possible while minimizing risks and optimizing patient outcomes. I'd be happy to see you for a clinical evaluation whether it be complimentary virtual consultation or an in-office appointment to discuss your options.   Please note – insurance can cover these procedures if your plan holds out of network coverage and the procedure is deemed medically necessary. My Silicone Coordinator can look into existing coverage during your initial call. (516) 279-2616

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding firm lips after lip silicone removal. I believe the firmness in your lips is due to scar tissue which is also called fibrosis. This is the way the body heals initially. I would suggest a deep tissue massage to break up the scar tissue. That is the most natural way. If you have significant firmness and scarring after 6-8 months, you may consider steroids. Personally, I like to avoid steroids as much as possible because steroids are an immunosuppressant. Therefore, I would suggest deep tissue massage be done almost all the time to break down your residual lip scar and fibrosis. I hope this answers your question regarding lip fibrosis after silicone removal.
I specialize in silicone lip removal and subsequent lip reconstruction.  I am the Director and chief clinical investigator at the Institute of Silicone Removal.  Since removing silicone from the lip is a delicate procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone from the lips.  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, lip silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Surgeons, 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, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Raffy Karamanoukian, MD, FACS · Answer

Our office specializes in the removal of liquid silicone from the face. Hard lumps may be due to some fibrosis or scar tissue reaction. These areas of fibrosis tend to soften with time. IIT injections and massaging with Plato's Scar Serum may help.Best,Dr. Karamanoukian;Los Angeles

Otto Joseph Placik, MD · Answer

Yes fibrosis and foreign body granuloma formation are the likely causes for the hard lumps. I would not advise any further interventions as you will likely suffer other complications such as atrophy or tissue necrosis.

Luis Lopez Tallaj, MD · Answer

The difference between real dermalfillers as hyaluronic acid or calcium hydroxiapatite is that they stay were we inject it and do not move, and of coirse it will absorb within a period of no more than 12 to 16 months dependind on the case and area. Alloplastic material such silicone and PMMA the invade the cells citoplasma and integrate with the closer tissues, also they migarte and causes deformitis with compromise of the micro circulation, a real nightmare. In some cases we can remove part of it, neve all of it, trying to recreate a temporal normality in the lips or someother areas of the face with the risk of severe deformities. It’s so important that prior to do cosmetic facial injections you verify the doctor choosen by you, and search about the brand of the product that this professional is pffering to you. Recently we posted a documentary in our youtube channel Lopeztallaj, Besos de plástico explaining everything involved with those ilegal injections for a real prevention. It has english subtitles.

Sam Lam, MD, FACS, FISHRS · Answer

Since I perform lip reductions almost every single week, I have tremendous experience with this procedure.  I would say the hard lumps that you are experiencing more likely than not represents scar tissue in the lip that would best respond to 5-FU injections.  I personally hate steroid injections because I think they carry too much risk of tissue atrophy.  If they are softer then it could be a mucocele, which is a retained or disturbed minor salivary gland tissue.  if that is the case and it does not resolve spontaneously then a surgical removal would be the answer.  If the mass is truly hard, then this is less likely the case.

	best,

	Dr. Sam Lam, Dallas, TX

Darryl J. Blinski, MD · Answer

Reasons are as follows: residual silicone/granulomas, scar tissue, poor surgery. Without photos hard to determine which cause. But seek another opinion.

	From MIAMI Dr. B

Richard P. Rand, MD, FACS (retired) · Answer

The injection liquid silicone is permanent and its potential problems can be permanent.  Experienced plastic surgeons have seen these problems from when it was used years ago.  Typically the doctors using it are younger and less experienced with it and want to convince you that you can avoid the need to repeat injections with products like Restylane.

	You either have scar tissue or an inflammed area of residual silicone.  I'd suggest you return to your doctor for appropriate therapy.

What is the Reason for Hard Lumps After I Had Lip Reduction to Take out Some Injected Silicon?

Answers (8)

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