How to Remove Silicone Filler?

Question

I recently had silicone as a filler added to an area of my nose. However, the second time, the doctor added too much and now the tip of my nose and side is enlarged/deformed. I need some advice as to how to remove this excess silicone (procedure, product or other injectable?). Is there a time period for doing this before the silicone harden and take a permanent form?

Steven H. Williams, MD · Answer

The silicone that was injected can be removed at any time but will require surgical intervention.
In my practice, we see patients that have had silicone injected in their face or body.  Many of these were done outside of the United States as most dermatologists and plastic surgeons recognize the problems that can occur with injecting free silicone into someone. 
The body will form scar tissue around the silicone, however depending on the injection techniques, removal can be challenging (Dr. K reviews some of the issues around injection techniques and the quality of silicone).
Removal of injected silicone from your nose may require an open rhinoplasty approach.  You may also need a procedure to reconstruct the defect at a later time.
Find a board certified plastic surgeon to help you with this difficult problem.
I hope this helps.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question about how to remove silicone from the nose. I would suggest surgical direct excision ASAP. The sooner the better. It is best to remove the silicone as soon as possible before any scar tissue build. The more scar tissue, the more difficult the removal becomes. Steroids, antibiotics, hyaluronidase and filler will not remove or melt silicone. The nasal silicone is permanent and needs to be removed with surgery. I specialized in lip biopolymer and silicone removal and subsequent reconstruction with fat grafting and/or implants. I am the lead investigator and founder of the Silicone Removal Institute. Since removing silicone is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience in removing silicone. Do your research. Make sure they have performed many 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, silicone removal surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, 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 and RealSelf Hall of Fame.)

Raffy Karamanoukian, MD, FACS · Answer

In theory, silicone is an inert facial filler with minimal risk of developing foreign body reaction. However, the number of documented cases of silicone granuloma, silicone inflammation, silicone deformity, and sensitivity to injected silicone is enormous.

The first step in dealing with silicone problems is to identify the exact source of the silicone injected.

Was it medical grade?

Where was it manufactured?

What is the lot number and expiration date?

Was sterile technique adhered to?

Once this information is acquired, the two components of silicone deformity need to be addressed separately:

Inflammatory phase
	
		Foreign body filler

Treating silicone deformities is difficult. Our office specializes in silicone filler removal.

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.

Karan Chopra, MD · Answer

Hi @Cola: Thanks for your question. 
Free Silicone should not typically be injected into the body. In the United States this is almost never performed because of the risk of Silicone Granuloma formation, Infection and nodule formation in response to the "foreign body" that has been injected into the body. 
Treatment options depend on your unique situation and are divided into the two phases the first phase is removal of the silicone or other black market fillers. The second is reconstruction of the area with your own tissues (typically your own fat is harvested from techniques similar to liposuction and then injected). 
Silicone Removal & Reconstruction is challenging but can be done. Be sure to consult with your plastic surgeon to discuss all your options.

Best of luck,
Dr. Karan Chopra
★★★★★
Minneapolis Plastic Surgeon
Face ⨀ Breast ⨀ Body Expert
Johns Hopkins Trained
Cosmetic Fellowship Trained

How to Remove Silicone Filler?

Answers (6)