This is an excellent consideration. Making the wrong choice can result in a long history of problems. I practice in Southern California and Las Vegas, NV. It is against the law to inject Silikon in Nevada. And, there is virtually no other medical severe prohibitions than this in Nevada. I have treated numerous women who had liquid silicone injected into the lips that produced a chronic inflammatory response (about 4% of patients) and produced enlarging lips, hard lips, and deformity of lip movements. This treatment is to excise all the inflammatory tissue containing the silicone, like dance surgery. After the surgery heals, then lip augmentation is contemplated and performed, usually with a soft silastic lip implant (Surgisils Permalip). Bellafill can be injected in all facial anatomical sites, excluding the bulk of the lips. If patients request a permanent lip augmentation, soft silastic implants are the recommendation. Facial volume loss can be treated with either silastic facial implants, facial fat transfer and Bellafill dermal filler, the only filler approved by the FDA for this purpose. The advantages of the silastic implants are that they can lift or suspend facial tissue, fill in the volume loss, and compress some of the acne scarring. Fat transfer has stem cells and growth factors to further improve the quality of the skin as well as fill in volume loss.We performed a study in five patients with acne scarring and volume loss treated with fat transfer and the acne scarring appearance was improved by 50% even prior to the Laser skin resurfacing procedure. The stem cells and growth factors are the most probable reason for this and a significant advantage for volume replacement in acne scarring as well as the placement could be used in all areas of the face. Bellafill is excellent for minor areas of volume loss, however, given the amount of volume replacement needed, this can get expensive since each syringe costs about $950. I prefer to use a microcannula for placement to minimize bruising, pain and lower risks of vessel injection. There is no treatment for excess liquid silicone injection except surgical excision. If there is excess Bellafill injected or granuloma formation, 95-99% of patients can be successfully treated with Kenalog. In summary, I strongly recommend NOT using Silikon. The other permanent options (silastic implants, fat and stem cell transfer, and Bellafill filler) should be considered with one recommendation better than another based on the anatomical site(s) to be injected and the amount of filler to be injected.