If Silikon 1000 is a Permanent Filler, then How Do Doctors Correct Mistakes or Migration Problems?

We have seen no cases of migration after 24 years using microdroplet Silikon-1000 as a permanent injectable soft tissue filler. Problems with Silikon-1000 are extremely uncommon (1-3% of treatments), and may be limited to three (3): 1)bumps, 2)redness, and 3)overcorrection. Any injectable filler, like HA, can cause bumps, and in our experience when bumps occur, we treat these with dilute steroid injections, or sometimes light electrosurgery in the office. Redness goes away with time, and we have had very good success speeding resolution of redness with our IPL machine. Overcorrection may occur if too many treatments are performed, and this is avoided with experience.

I must add that there are ZERO cases of necrosis, blindness, biofilm formation, stroke, or infection after microdroplet Silikon-1000 because the size of a molecule of polydimethyl-siloxane is smaller than a red blood cell, unlike HA and other temporary gel fillers. In the right hands, microdroplet Silikon-1000 may be safer than temporary gel fillers. You can google "HA necrosis" to see graphic photos demonstrating dead skin after a temporary gel filler. Try the same with "Silikon1000 necrosis" and you will see the difference is truly eye opening. Thanks for this terrific question! Dr Joseph

Hello, and thank you for your question about correcting mistakes or migration after Silikon 1000 injections.

Silikon 1000 is a permanent filler, which makes managing complications like migration or mistakes far more challenging than with temporary fillers. Because silicone does not degrade or dissolve over time, any issues that arise—whether immediately or years later—must be addressed through surgical removal. This is a delicate and often invasive process that can result in permanent scarring or tissue loss, depending on the extent of the problem.

Migration of silicone is not uncommon. Over time, the silicone microdroplets can shift from the original injection site, often leading to lumps, asymmetry, or deformities. This can happen even with precise placement, as the body’s natural movement and immune response can gradually displace the material. Once migration occurs, it is impossible to reverse or "dissolve" the filler like you can with hyaluronic acid fillers.

The process for correcting migration or complications involves surgically excising the silicone along with the surrounding tissue. In delicate areas like the face, this can be particularly complex. For example:

In the lips, silicone removal often requires excising part of the lip tissue itself, which may permanently alter the shape or size of the lips.
In the nose or other facial areas, removal might involve incisions such as those used in rhinoplasty or facelift procedures, where the skin is peeled back to access and remove the silicone.
The surgical removal process carries its own risks, including scarring, contour irregularities, and incomplete removal of the silicone. Additionally, residual silicone left behind after surgery can continue to cause problems, such as inflammation or granulomas, requiring further interventions.

Given these risks, I strongly discourage the use of Silikon 1000 or any permanent fillers. Safer, temporary alternatives like hyaluronic acid fillers offer excellent results with minimal risk and the ability to dissolve them if complications occur.

If you are considering Silikon 1000 or have already experienced migration or other issues, I recommend consulting with a board-certified plastic surgeon or dermatologist who specializes in filler complications. Surgical correction can be complex, but it is often the only solution for addressing problems associated with permanent fillers.

I hope this provides clarity on the risks and the process for addressing complications with Silikon 1000. Please make an informed decision and prioritize your long-term health and safety.

Sincerely,
J. Timothy Katzen, MD

  I disagree with the others who replied.  You ask an excellent question and you apparently understand that Silikon 1000 is a permanent filler.  The benefit of that fact is obvious. The truth is that I have seen terrible long lasting results from other fillers and from fat too, and have NOT been satisfied that hyaluronidase relieves all the problems such as prolonged edema and festoons the HA fillers may cause.  The key to getting Silikon 1000 is to choose an expert injector.

Silikon 1000 is FDA approved for use in very small quantities in the retina.  Although it is a much more refined product than industrial grade silicone, its long term behavior is too unpredictable to recommend to anyone for aesthetic use.  Given the availability of excellent medium to longer lasting semi-permanent fillers and volumizers such as Radiesse, Juvederm, Restylane, Sculptra etc. the relevance of silicone based products has been greatly diminished. There is no good or reliable way to deal with silicone filler complications, especially when used in higher volumes.

This is a good question. Yes, Silikon-1000 is a permanent filler, there is no question about it. It is the only recognized permanent filler. If there is a doctor mistake it is usually because of over-filling. That is why the ideal technique is to place microdroplets over a period of time. Usually, it is two to three sessions. Therefore, one would not over-fill. It is like building a house. One floor at a time. It begins with a small injection, then six or more weeks later an additional injection is layered onto the previous one. Hopefully after that, or one more injection or so, the endpoint has been achieved. It is important to do it incrementally because that is the safe way and in how nature handles it.

I have not seen a migration problem in the nose because the nose is a non-moving part. The product is thick and stays where it was placed and then nature builds a protective wall around it. Migration is nearly impossible. Plus, remember, the nose is the ideal location because it is a non-moving part. There is no muscle contractions that would interfere with the permanent fixation of the silicone in the tissues by the microscopic wall that natures build around it. Migration is very rare in any location because the product is thick and unlikely to disperse itself. More common in a site of movement would be that the wall around it become thicker than necessary and therefore visible and palpable but that is very rare.

Regarding: "How common is it to experience migrations after use of Silikon 1000? What is the process for reversing the problems that might occur with this filler?"

You nailed the nail on the head. A permanent (or very long acting filler) is associated with permanent (or very long lasting results). If the results are good - you hit the jackpot. However, if the results are mediocre or poor you will have to accept irreversible poor results.

With the great variety of long-lasting temporary fillers on the market it makes complete sense to stay away from permanent fillers. Furthermore, are you aware that Silicon 1000 and other similar fillers were never approved by our FDA as soft tissue fillers but are used as an "off label" indication?

Peter A Aldea, MD

Your point is excellent!  The fact is that you can't manage effectively the problems with permanent fillers so I personally would never offer them to anyone.  Temporary fillers are the way to go!