Complications from liquid silicone injections have reached epidemic proportions. Our office sees patients from around the world who have undergone silicone injection in various parts of the body. The lips, hips, thighs, and buttocks are common areas of injection. Patients with silicone in their bodies may desire removal of the silicone because of unwanted swelling, redness, infection, inflammation, pain, discomfort, and ulceration. These are very difficult problems to solve and a regimented protocol is necessary to achieve acceptable results and maintain aesthetic contour.
Removal of Silicone from the Lips
Silicone is often injected into the upper and lower lip areas. Unlike temporary lip augmentation with Juvederm or Restylane, liquid silicone does not dissolve with time. On the contrary, silicone is a permanent filler that not only stays in the body, but often develops into bigger inflammatory nodules that are known as granulomas. Some patients will also develop non-nodular swelling, itching, burning, and pain that is directly attributed to the silicone itself.
The treatment of lip silicone or lip nodules is difficult. Treatment begins with the injection of corticosteroids to decrease the inflammatory effects of the silicone itself. These injections should be performed by a physician who is familiar with the treatment of silicone in the lips, as complications can occur. In practice, silicone that is minimally-responsive to corticosteroids can be surgically removed using a variety of techniques. These procedures are usually performed in an outpatient surgical suite under anesthesia.
Dr. Raffy Karamanoukian is an expert in the treatment of silicone injection complications. He performs surgery for silicone nodules, lumps, and silicone complications using surgical and non-surgical methods.
Removal of Silicone from the Buttocks
Silicone injections are commonly injected into the soft tissue of the buttocks and hips in order to enhance the contour and volume of the lower torso, buttocks, and thighs. Women who desire a Brazilian Butt Lift may opt for silicone injections if there is no available fat to harvest as donor tissue for fat transfer; but fail to appreciate the longterm risk of soft tissue inflammation and granuloma formation.
The removal of liquid silicone from the buttocks is possible if there is limited fibrosis of the soft tissue. Prolonged inflammation may damage the underlying vascularity of the soft tissue, making it increasingly difficult to safely remove the liquid silicone after extended periods of time. If you have liquid silicone injections in the buttocks or hips, it is imperative to seek early treatment to mitigate the longterm effects of chronic inflammation, soft tissue fibrosis, granuloma formation, and scarring.
Dr. Raffy Karamanoukian is renowned for his surgical protocols to remove silicone from soft tissue. He has developed the Karamanoukian Soft Tissue Grading Scale for soft tissue reaction following the administration of silicone injections. If you are experiencing problems associated with liquid silicone injections into the buttocks, a consultation can help you understand your options for treatment.
Removal of Silicone Oil from the Face
Although silicone oils (Biogel, Biopolimero, Bioplastique, and Biosil) can be injected anywhere on the face and body, it becomes more and more complicated to remove the silicone from aesthetically-important areas such as the nose, eyes, cheeks, and chin. Surgical removal of silicone is further complicated by the anatomic restrictions imposed by important neurovascular structures that can be injured if the silicone is removed.
Dr. Karamanoukian is a leading expert in the removal of silicone from the face and body. During your consultation, he will evaluate the Karamanoukian Grading Scale for soft tissue reaction to determine if there are surgically-feasible options for silicone removal. In some cases, the risk of silicone removal may outweigh the benefits; making it exceedingly difficult to justify the removal of silicone in an elective setting. In cases of symptomatic granuloma formation, ulceration, chronic tissue fibrosis, and infection, there may be a medical justification for emergent removal.
Removal of Artecoll
We are often asked to remove Artecoll products from the face, especially around the eyes and the marionette lines of the lower face. Artecoll filler can incite a dense inflammatory reaction leading to granulomas, or hard nodules within the skin. It is often difficult to differentiate Artecoll granulomas from normal tissue because there is a less defined interface between the two. In some cases, hard nodules can be removed by Dr. Raffy Karamanoukian using defined protocols for granuloma clearance. Surgical options remain the gold standard for treatment.
Cases of symptomatic granulomas from Artecoll or Artefill can be managed with non-surgical options, including intralesional therapy. A consultation at Kare Plastic Surgery + Skin Health Center can help you define your options.
Removal of Bellafill
Bellafill is an FDA-approved filler formulated to treat nasolabial folds and moderate to severe atrophic facial acne scars. Our Santa Monica plastic surgery office specializes in the removal of Bellafill and Bellafill granulomas from the face using a surgical approach. Bellafill is composed of collagen and polymethylmethacrylate (PMMA) and can cause granulomas and scarring. Dr. Raffy Karamanoukian can help formulate a surgical plan that removes the filler with minimal complication and risk. Unwanted Bellafill may cause nodules and persistent edema.
Removal of Bioplastique
Our office has had several patients who have undergone successful removal of Bioplastique from the soft tissue of the lips and face. This particular filler is often of questionable provenance and thus has variable complication profiles. Bioplastique silicone can be removed from the lips using Dr. Raffy Karamanoukian's pioneering techniques. Surgical removal of Bioplastique from the soft tissue of the face is limited by anatomy, particularly neurovascular structures that may be at risk during surgical excision.
Removal of Biopolimero
Biopolimero, Biopolimer, Biogel, and Biopolymers are a group of non-FDA approved fillers that are used for soft tissue volume augmentation on the lips, face, and body. Our office consults on Biopolymer injections to the buttocks and face; and our expert plastic surgeon, Dr. Raffy Karamanoukian, has developed a protocol to remove unwanted Biopolymers from the soft tissue.
Removal of Dermagen
Dermagen is a mineral oil/silicone polymer that has been used for soft tissue augmentation of the face and body. Removal of Dermagen should be initiated early, as longterm exposure to Dermagen within the soft tissue can lead to chronic inflammation, granulomatous reaction, and soft tissue fibrosis. Dr. Raffy Karamanoukian is an expert in Dermagen removal, if possible, from the face and body. Surgical removal of Dermagen is limited to those areas where critical nerves are not compromised during treatment.
Removal of Restylane and Juvederm
Juvederm and Restylane Hyaluronic acid facial fillers can be readily removed using Hyaluronidase enzymes Vitrase and Hylenex which dissolve the injected material using enzymatic activity. Unlike silicone and Artefill injections hyaluronic acid is reversible without surgery. A small subset of our patients, however, do not respond to treatment because the material is a more viscous form of hyaluronic acid or not Juvederm or Restylane at all.