Silikon 1000 in nose, discolored bump - can this be fixed with a nonsurgical procedure? (Photos)

Question

In 2017 I had Silikon 1000 injected into the left side of my nose to correct a slight dip. The doctor injected too much and now I have a discolored bump on the left side of my nose. Can this be corrected without a whole surgery? Like maybe with local numbing and excision?

Anna Chacon, MD, FAAD · Answer

A bump and discoloration several years after Silikon 1000 (liquid silicone) injections can be challenging because the silicone is permanent and can cause a localized inflammatory reaction, fibrosis, or changes in the overlying skin. The discoloration may also indicate that the tissue has been affected by the injection itself.

If the problem is very localized, it may be possible to improve it with a small, targeted procedure under local anesthesia, rather than undergoing a full rhinoplasty or extensive surgery. However, whether a simple excision is appropriate depends on how deep the silicone is, whether it is confined to the bump or spread into the surrounding tissue, and how much of the skin and underlying tissue is involved.

I would be cautious about simply cutting out the visible bump without first determining what is underneath it. Removing silicone-containing tissue from the nose can leave a depression, contour irregularity, or additional scarring, particularly if the silicone has become incorporated into the surrounding tissue.

Nonsurgical options are generally limited once permanent silicone has been injected. Treatments such as steroid injections may sometimes help if there is an inflammatory or granulomatous component, but they do not remove the silicone and can potentially thin the tissue if used improperly. Laser or other treatments may help with discoloration in selected cases, but they would not address a significant underlying silicone deposit.

Given that this has been present since 2017, I would consider a focused examination of the bump and the surrounding skin to determine whether a small local excision, possibly under local anesthesia, could safely correct the contour and discoloration. The goal would be to remove or reduce the problematic tissue while preserving as much healthy nasal tissue as possible.

So, yes, a limited procedure under local numbing may be an option, but I would not consider it equivalent to a simple "bump removal." The anatomy of the nose and the way permanent silicone can become intertwined with the tissue make the surgical planning particularly important.

Nelson Lee Novick, MD · Answer

I'm sorry that this has happened to you, and it is for potential complications and adverse reactions such as this that I have been cautioning my regular followers for years to avoid the lure of permanent fillers, since permanent fillers can translate into long-lasting to permanent complications. I can certainly understand the allure of getting something permanent, but the real risk of difficult-to-treat complications is simply not worth it in my opinion. 
That being said, I have had success in treating such complications nonsurgically in people to coming to me after having been treated elsewhere with silicone injections or Bellafill using an algorithm of varying combinations, concentrations and amounts of intralesionally injected anti-inflammatory agents to shrink the fibrosis that inevitably encapsulated the foreign body material (I.e. the silicone) that was injected. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist before embarking on surgery, which poses the risk of stretch scars and stitch tracks, particularly in areas under static tension, such as the nose. Hope this helps and best of luck.

Silikon 1000 in nose, discolored bump - can this be fixed with a nonsurgical procedure? (Photos)

Answers (2)

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