Thank you for your question regarding the options for managing complications from liquid silicone injections in your face. It's unfortunate that you are experiencing these issues, but you are right to seek thorough and safe treatment options. Liquid silicone injections to the face are generally considered unwise and unsafe due to the numerous risks they pose. These injections can provoke inflammatory reactions, create excessive scar tissue, and potentially trigger autoimmune diseases. Conditions linked to silicone injections include Hashimoto’s thyroiditis, Rheumatoid arthritis, sarcoidosis, and ulcerative colitis, among others. Moreover, silicone can cause significant metabolic issues such as hypercalcemia, which may lead to kidney stones, kidney failure, and even the need for a kidney transplant. Additionally, silicone can migrate and cause severe granulomas and disfigurement. Regarding the removal of silicone and associated scar tissue from the face, there are generally two approaches: Direct Approach: This involves making an incision over the area where the silicone and scar tissue are concentrated. However, making incisions on the face can lead to significant disfigurement, though sometimes such measures are necessary. Facelift Incision Approach: More commonly, an incision similar to that used in facelifts is made in front of the ear. This type of incision allows extensive access to the face and has the benefit of hiding the scar effectively. Additionally, by using this facelift approach, any tissue removed can coincide with tightening the skin, which may improve the overall aesthetic outcome. As for the return of nerve function, regrettably, this is unlikely if the damage is extensive. Concerning your question about the use of radiofrequency laser treatments, while these can help break up scar tissue, they will not eliminate the silicone. Furthermore, the heat from the laser could potentially cause the silicone to spread further, worsening the problem. Most plastic surgeons advise against using laser treatment for silicone injections due to these risks. This is indeed a challenging problem, but there are specialists who focus on the removal of silicone from the face. I recommend consulting with a plastic surgeon who has specific experience in this area to discuss the most appropriate and safe treatment options. Good luck, and I hope this information helps you in finding a resolution to your concerns. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon