Can silicone injections be removed by Cool Laser?

Question

Can silicone injections be removed by cool laser and not leave disfigurement even if the the silicone and skin tissue are completely mixed?

Carlos Alberto Ríos García, MD · Answer

I understand your concern. Many patients hope there may be a less invasive way to remove silicone injections while avoiding major deformity or tissue loss.
Unfortunately, when liquid silicone has been injected and becomes diffusely mixed with the skin, fat, scar tissue, lymphatic structures, and sometimes even muscle, it usually cannot simply be “melted” or fully removed with laser treatments alone.
At this time, there is no widely accepted evidence showing that so-called “cool laser” treatments can reliably remove infiltrated silicone from the tissues without risk. In some situations, certain energy-based devices may be used as supportive treatments for fibrosis, skin quality, or inflammation management, but they generally do not eliminate deeply infiltrated silicone material itself.
One of the biggest challenges in silicone removal surgery is that the body’s normal tissues often become intertwined with the injected material over time. Because of this, aggressive removal can sometimes lead to contour irregularities, dents, skin compromise, or deformity, especially when the silicone is widespread.
The safest surgical approach depends heavily on:
* how diffuse the silicone is* whether there is active inflammation or migration* skin and tissue quality* and how much normal tissue can realistically be preserved
Cases like these often require very individualized reconstructive planning focused not only on removal, but also on preserving tissue viability and long-term contour as much as possible.

Jeremy S. Nikfarjam, MD · Answer

Hi Gorgeous557978!

Great question — and it’s a very important one when managing complications of silicone injections.
The short answer unfortunately is no. Silicone injections cannot be effectively or safely removed using cool laser (or any type of laser alone), especially when the silicone is intermixed with skin and soft tissue. Lasers may help manage secondary issues like scarring, or pigmentation, but they cannot extract or dissolve silicone from tissue, particularly in deeply integrated or granulomatous cases. Silicone is not light-absorbing in the way that pigmented lesions or vascular targets are. It doesn’t respond to photothermal or photomechanical effects. "Cool laser" (which usually refers to low-level laser therapy or non-ablative fractional lasers) might reduce inflammation temporarily but won’t affect the silicone itself. In cases where silicone has diffused into soft tissue, forming granulomas or fibrosis, lasers can't differentiate or selectively destroy those particles without damaging the surrounding tissue. Attempting to “melt” or “dissolve” silicone with energy-based devices can cause more inflammation, migration, or scarring. Lasers can actually worsen the problem and are not recommended.

The best, most effective method to remove silicone would be by surgical excision. When done carefully (often through meticulous subunit-based or layered removal), disfigurement can be minimized or avoided, especially if paired with reconstructive techniques. In most cases, staged procedures or fat grafting may be needed afterward to restore contour or symmetry.

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 two-stage surgical excision process and a third stage of reconstruction (often referred to as a reconstructive BBL). 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 a complimentary virtual consultation or an in-office appointment to discuss your options. My Silicone Coordinator has undergone silicone removal and reconstruction and would be happy to get the ball rolling to see how we can help.  (516) 279-2616

J. Timothy Katzen, MD, FACS · Answer

Hello and thank you for your question regarding the possibility of removing silicone injections with a cool laser.

Unfortunately, silicone cannot be removed with a cool laser. A laser, by nature, is a form of heat energy applied to soft tissue. This heat cannot evaporate, dissolve, or magically make the silicone disappear. Silicone is an inert material, which must be manually removed via surgical procedures. Therefore, it cannot be removed with a laser alone. While sometimes a cool laser can be combined with a suction technique to help remove the liquefied silicone, in isolation, the cool laser is not capable of removing silicone.

If suction isn't a good option, you may need to get the silicone resected by incision. I'm sorry if this is not the news you wanted to hear. Please schedule a consultation so we can see the best route for your silicone removal.

I hope I’ve helped to answer your question regarding the use of cool lasers for silicone removal.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

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

Can silicone injections be removed by Cool Laser?

Answers (4)

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