Purified Polydimethylsiloxane (Silicone) as Dermal Filler Resolving the Controversy?

Dermal fillers are widely used in Medical and Surgical Cosmetic practices. Temporary and semipermanent fillers are more commonly used for a wide variety of reasons; however, permanent fillers represent an excellent option in properly selected patients. The aim of this study is to evaluate the off-label use of Silikon 1000 (S1000) as a permanent filler analyzing safety, durability, and patient satisfaction. This was a retrospective chart review of prospectively collected data. The study included 25 patients who underwent S1000 injection in 32 treatment areas. The following parameters were assessed: age, gender, weight, height, body mass index (BMI), number of treatments, duration of treatments, follow-up, complications, and interventions. Patients who had other fillers injected into the same area within 1 year before or after the S1000 injection were excluded from the study. In all, 32 treatment areas in 25 patients (21 females, 4 males) were included in the study. Five female patients received S1000 in more than one area. Treatment areas included the following: nose (n = 4), lips (n = 16), glabella (n = 4), nasolabial folds (n = 3), scars (acne or others) (n = 2), orbital rim (n = 2), and perioral (n = 1). Extrusion of silicone, migration, cosmetic deformity, hematoma, seroma, and infection were considered as inclusive criteria for injection complications. None of the patients developed any complications along the course of follow-up that ranged from 8-38 months; therefore, no intervention or surgery was needed to treat any adverse outcomes. All patients reported high satisfaction with the cosmetic results. Off-label use of highly purified polydimethylsiloxane as dermal filler is safe and durable. Being conservative is key to optimize outcomes and avoid complications. Proper approach involves injection of small doses using microdroplet technique to augment the tissue gradually over sessions at 1-2 months apart. Complications as silicone migration and irregularities can be largely avoided by following proper techniques and understanding the unique mechanism of action of S1000 compared with traditional fillers.

Gluteal Augmentation With Liquid Silicone of Unknown Purity Causes Granulomas in an Adult Female

Background:A 39-year-old woman presented with a history of relapsing painful erythema and progressive fibrosis of the lower back. Upon questioning, the patient admitted to receiving liquid silicone (LS) injections for gluteal augmentation abroad and was diagnosed with silicone migration, granulomatous reaction, and fibrosis of the lower back.Objective:To review the history of LS injections for cosmetic soft tissue augmentation (STA) as well as its complications and potential treatments.Methods:The author reviewed articles that involved the use of LS for STA and summarized their findings.Results:The author summarizes the various treatments that have been described for inflammatory reactions following LS injection.Conclusion:The growth of cosmetic medical tourism and its inherent lack of after-care as well as patients’ ability to obtain restricted products at home raise the likelihood of encountering granulomatous or fibrotic reactions to fillers during consultations. Physicians should have a structured approach to these patients.