Is Silikon 1000 a Bad Idea?

  As you can see, there is no uniform opinion on this subject.  I read in a journal that about 40% of doctors who do lip injections use Silikon 1000 and love it and the other 60% who do not use it swear that it is unsafe and that it should not be used.  Yes, it is an off label use this product but so is using Botox for cosmetic purposes in any location other than the frown lines between the eyebrows. Personally, I think Silikon 1000 is an ideal filler, used in the proper manner, by an experienced injector.

Hello snl1989, and thank you for your question about Silikon 1000 injections for fuller lips. I strongly advise against using permanent fillers like Silikon 1000 for several important reasons. While it is a liquid silicone, its permanence comes with significant long-term risks. Unlike temporary fillers, such as hyaluronic acid fillers, silicone cannot be dissolved or safely metabolized by the body. Once injected, it stays in your tissues permanently, and any complications that arise—whether immediately or years later—are extremely difficult to correct.

One major concern is migration, where the silicone can move from the injection site over time, leading to asymmetry or deformities. Another risk is the formation of scar tissue and hard nodules as your body reacts to the silicone. Over time, this can cause unevenness, lumps, or firmness in the lips. Additionally, silicone can trigger chronic inflammation, and in severe cases, issues like necrosis (tissue death) or systemic autoimmune responses (ASIA syndrome). Even if the injection initially appears fine, complications such as drooping, deformity, or swelling can develop years down the line.

If you decide later that you no longer want the silicone, removal is a significant challenge. In the lips, this typically requires surgical excision, which involves cutting out the silicone and the surrounding tissue. This can lead to permanent changes in the size and shape of your lips, as well as visible scarring. These risks make silicone an incredibly high-stakes choice compared to temporary fillers.

If you’re looking for fuller lips, I highly recommend temporary hyaluronic acid fillers such as Juvederm or Restylane. These fillers provide excellent, customizable results and can be dissolved if needed. While temporary fillers may require periodic touch-ups, they come with significantly lower risks and allow for adjustments over time.

I understand your concern about avoiding sagging or deformed lips later in life, and for this reason, I cannot recommend permanent fillers like Silikon 1000. I hope this information helps you make an informed decision. Please consult with a board-certified plastic surgeon or dermatologist to discuss safer, more reliable options for achieving your desired look.

Sincerely,
J. Timothy Katzen, MD

I would be very careful about receiving Silikon 1000 injections for volume enhancement.  The microdroplet technique is supposed to diminish the disastrous results seen from bulk injections of a few decades ago.  The negative side effects might not show up for many months or years so I would proceed with caution.  Undoing an unwanted result might be impossible.

Silikon 1000 is intended for use in the eye. It's use for lip augmentation is considered "off-label" by the FDA. The results are highly dependent with an emphasis on using the microdroplet technique. This requires multiple sessions over months and perhaps even years. The best results are acheived with conservative injections to create full and not necessarily LARGE lips. Complications may be a direct result of the injection technique. Improperly placed silicone can create a permanent problem that may be impossible to remove or correct.

Silikon-1000 is a permanent filler, so your results, good or bad, are permanent. You must find a board-certified dermatologist or facial plastic surgeon experienced with the serial puncture, micro-droplet technique. You should also have a discussion with your doctor about the FDA's position with respect to using Silikon-1000 in an off-label fashion to enhance your lips. Lastly, you should see many before and after photos demonstrating beautiful results before you pick your doctor and proceed.
Complications with well-performed Silikon-1000 injections are infrequent. You could develop a nodule or bump in the area of injection (2% of procedures). Silicone bumps are treated with dilute triamcinolone injections, or rarely excision.
I've attached a link to my Lip Enhancement photos for your perusal.
I hope you find this helpful.

Not if it is used right. It is a wonderful idea to correct imperfect noses after one, two, three or more unsuccessful rhinoplasties and it is a good idea if a patient has a low bridge or a crease between the tip. These are natures imperfections that are very well managed with the efficient, less expensive, and permanent medical-grade liquid silicone.

Silikon 1000 is sterile silicone oil (purified polydimethylsiloxane) manufactured by a Swiss company called Alcon, Inc. The product was developed for use by ophthalmologists to treat retinal detachment and is FDA-approved for that indication only. Subcutaneous injection of silicone oil for facial soft tissue augmentation is an off-label (non-FDA-approved) use, and remains controversial. Silicone granules are treated by the body as numerous, miniscule foreign objects and in many patients can elicit a chronic inflammatory response and granuloma (cyst) formation. Subcutaneous injection of silicone oil can also be complicated by acute and/or chronic infection as well as migration of the silicone particles. Infections may be difficult to treat as the silicone material, once injected subcutaneously, cannot be removed.

Just to be clear, this is a very different material than what is used in contemporary silicone gel breast implants. Cohesive silicone gel implants are filled with silicone gel that is in a solid state, and which is contained by a solid silicone elastomer shell. Silicone oil, on the other hand, is a viscous liquid, which in fact is used as an industrial lubricant. Think hard about whether you want this kind of material injected into the subcutaneous tissues of your face. It's the only face you've got.

Silicone material injected into the subcutaneous space may look fine in terms of soft tissue enhancement for week, months or even years, and then begin to manifest some of these unpleasant and difficult to treat problems at a later date. It never goes away, so the recipient is potentially at risk for these complications for the rest of their life. I personally could not in good conscience inject this material into anyone's face. I have evaluated patients with silicone granulomas (cysts) and/or chronic infection that developed over five years after subcutaneous injection, and there are reports of these complications appearing over 10 years following injection. I am certain that there are some patients who never manifest any of these problems, but why roll the dice?

In the 21st century, patients seeking permanent facial soft tissue enhancement have the luxury of choosing a naturally occurring, non-toxic, safe, effective, and extremely well-tolerated filler: their own fat. Structural fat grafting is the process of harvesting fat from the trunk and/or thighs and transferring it to facial sites that require volume enhancement. It has no limitations anatomically - one can beautifully, naturally and permanently fill the temples, peri-orbital (eye) area, cheeks, lips, nasolabial folds, marionette lines, jawline, etc. It does not incite an inflammatory response or immune response, and it will never be rejected by the body. Fat also contains stem cells, which are dynamic cells that have a remarkable capacity to repair human tissues. Many facial fat grafting patients tell me that the quality of their skin improves dramatically in the months following fat grafting, and many plastic surgeons who perform a great deal of fat grafting procedures believe that stem cells are responsible for this effect (myself included).

So if fatty soft tissue volume is what is missing (which is the primary process of facial aging), it makes perfect sense to replace it with fat. It doesn't make much sense to me to replace it with a material used as an industrial lubricant.

Fat grafting is also a reasonable option cost-wise compared to non-fat soft tissue fillers, but cost is not the primary issue here. Your face is priceless, and you should treat it that way when considering the risks and potential complications of any injectable filler. Particularly ones that are not FDA-approved for injection into the subcutaneous tissue of the face.

In the hands of a board-certified dermatologist or facial plastic surgeon with expertise and experience in using liquid injectable silicone (LIS), LIS is an excellent filler for lip augmentation.  As mentioned, it is permanent.  It is also incredibly precise and provides very natural-looking results.  If injected properly by an experienced injector, you should not have droopy or deformed lips.  Quite frankly, any filler that is poorly or improperly injected into the lips by an inexperienced injector can result in complications and/or a less than desireable cosmetic outcome.  Feel free to check out our website where we have lots of information and pictures on silicone and lip augmentation.