Microdroplet silicone injections can be used to rebuild tissue in desired sites by stimulating the body’s own collagen production. Used for decades in the skin, liquid silicone oil can be used to fill several types of wrinkles, scars and facial contours, including lips, that have been altered by time or trauma.
An extremely ubiquitous agent, silicone is one of the most inert, or non-reactive, substances in the world. As a major ingredient in makeup, conditioners, skin care products, and used as a medical lubricant for needles and syringes, we have all been exposed to it. Medical-Grade Silicone oil is sterile and highly purified, requiring no skin testing prior to treatment. Currently there are two liquid silicone products that are approved by the FDA for use in eye during severe retinal detachment. Silikon 1000® and Adatosil 5000® are marketed for this purpose. Although the FDA has not specifically approved the cosmetic use of the agent, the FDA modernization act of 1997 allows licensed physicians to use these agents “off label” for other purposes; similar to the numerous uses for Botox®. With its long history of safety and a sterile, medical-grade composition, silicone oil (Silikon 1000) is an excellent filler for most areas of the face. Currently, a similar silicone product is being scientifically evaluated for potential FDA approval in the treatment of HIV-Associated Lipoatrophy of the face.
Injectable Silicone as a Filler
Since the era of the silicone breast implant controversy, several misconceptions have plagued silicone’s reputation. In March of 2000, the New England Journal of Medicine released an article that reviewed the data comprised by a group of eminent scientists from various medical specialties that unanimously concluded that there was no evident link between silicone and systemic disease of any kind.
Unfortunately, the use of silicone in the skin has also experienced some controversy due to the varying techniques and illegal silicone substances that have been abused by both physicians and non-physicians. Several forms of non-sterile, non-medical grade silicone oil can be purchased through industrial suppliers and illegally injected into the skin. Most often both poor substance quality and large volume injection technique led to greater risk of patient complications and unnatural aesthetic results*.
The microdroplet technique entails the injection of numerous small drops (about 1/2 a drop of water) of sterile silicone oil into several points within a desired site. When injected, the liquid silicone remains chemically unaltered and is subsequently surrounded by a collagen capsule produced by the patient’s skin. Treatments are conducted at monthly intervals to allow for collagen rebuilding and a resulting natural appearance*. This technique overwhelmingly minimizes the occurrence of overcorrection and potential drift (movement or shifting) of the silicone that has been seen with other techniques that involve large volume injections.
The number of treatments varies depending on the number of desired sites and the extent of augmentation needed. The cosmetic use of silicone oil is compatible with other procedures including lasers and surgery, although a history of its use should be provided to all treating physicians. The microdroplet technique of silicone oil provides a slowly progressive and very natural appearing result in all areas of potential treatment*. It is often less painful that other fillers and patients can resume their daily activity, without restrictions, immediately*.
Although cosmetic silicone oil injections using the microdroplet technique suggests a very good safety and efficacy record, all cosmetic procedures do carry some degree of risk and uncertainty. Although very rare (on the order of a fraction of 1%) possible side effects include- transient bruising and swelling, overcorrection, rare discoloration (in thin skinned scars), firm texture, and an idiosyncratic inflammatory reactions that produces redness and swelling. Fortunately these reactions are extremely rare and can be minimized in their occurrence with appropriate substance and technique. In their occurrence, they can often be managed with a variety of procedures including local cortisone injections, removal of tissue, electrodessication and antibiotics. In some instances, time alone resolves the problems. For these reasons, it is essential for patients to seek a licensed, board certified physician with expertise in the use of silicone and its potential complications. They must use the medical-grade Silikon 1000 or Adatosil 5000 product and use the microdroplet technique, the only substance and technique used in our practice.
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