Kare Plastic Surgery & Skin Health Center · Los Angeles
Silicone Lip Reduction in Los Angeles
804 7th Street, Santa Monica, CA 90403 · Near Montana Avenue · (310) 998-5533
Open lip reduction surgery and silicone removal for overfilled lips by world authority on silicone disease Dr. Raffy Karamanoukian, dual board-certified plastic surgeon at Kare Plastic Surgery in Santa Monica
Call (310) 998-5533 Request a Consultation
804 7th Street, Santa Monica — Near Montana Avenue
(310) 998-5533
World Authority on Silicone Disease Dual Board-Certified Plastic Surgeon
UCLASchool of Medicine Graduate
WorldAuthority on Silicone Disease
Open &Cheiloplasty Technique
HiddenIntraoral Incisions — No Visible Scar
National &International Patients Accepted
Silicone Lip Reduction Los Angeles
The Surgeon Who Corrects What Others Couldn’t Fix
Dr. Raffy Karamanoukian, MD, FACS Dual Board-Certified Plastic Surgeon Graduate, UCLA School of Medicine · World Authority on Silicone Disease · Kare Plastic Surgery, Santa Monica
When lips have been overfilled with liquid silicone, the result may be a lifetime of chronic foreign body tissue reaction.
At Kare Plastic Surgery & Skin Health Center, dual board-certified plastic surgeon Dr. Raffy Karamanoukian, MD, FACS performs silicone lip reduction for patients throughout Los Angeles who have been told their lips cannot be corrected. His results demonstrate otherwise.
Patient Result — @kareplasticsandskin · Instagram Verified
Silicone Lip Reduction — 3-Stage Result
Actual patient of Dr. Raffy Karamanoukian · Individual results may vary
Stage 1 Before
Stage 2 1 Week Post-Op
Stage 3 3 Months — Final
Open Cheiloplasty Technique
Local Anesthesia — No GA Required
3 Months To Natural Final Result
Before: Massively overfilled lips with characteristic firmness, abnormal vermilion contour, and visible surface irregularity from silicone-laden fibrotic tissue. 1 week post-op: Early healing phase with expected swelling and healing incision. 3 months: Natural, beautifully proportioned lips with restored vermilion border architecture, normal lip movement, and no visible external scarring — Dr. Raffy Karamanoukian, MD, FACS · Kare Plastic Surgery, Santa Monica
Why Silicone Is Different
Silicone Lip Overfilling: Why This Is Not a Standard Lip Reduction Case
Standard lip reduction surgery — performed for congenitally large lips or overfilling with easily dissolved HA fillers — is a technically accessible procedure for any experienced plastic surgeon. Silicone lip reduction is categorically different, and the difference is tissue biology. Liquid silicone injected into the lips triggers a chronic foreign body inflammatory response that produces a specific tissue architecture: fibrotic granuloma capsule formation around silicone deposits, dense adhesion between the silicone-laden tissue and the underlying orbicularis oris muscle fibers, and a firm, rubbery lip texture that reflects years of low-grade inflammatory activity within the tissue.
Excising silicone-infiltrated lip tissue therefore requires dissecting the foreign material and its associated fibrosis away from the orbicularis oris — the primary muscle of lip movement responsible for eating, speaking, smiling, and kissing — without damaging the muscle function that must be preserved for normal post-operative lip performance. This is the technical demand that distinguishes silicone lip reduction from standard cheiloplasty and that requires the specific combination of reconstructive lip surgery expertise and silicone disease knowledge that Dr. Karamanoukian uniquely provides.
ZeroEffect of hyaluronidase on liquid silicone — surgery is required
HiddenIntraoral incisions — no visible external scar on face or lips
1–2 hrTypical silicone lip reduction under local anesthesia
3 monthsFinal natural result — as demonstrated in Dr. Karamanoukian’s case above
“Silicone lip reduction is not simply lip reduction with silicone present. The silicone changes the tissue. It creates fibrosis, it adheres to the muscle, it fragments when you try to remove it as a discrete mass. You need to understand the silicone pathology as intimately as you understand the lip anatomy — and be prepared to work in a tissue environment where the two are inseparable.”
— Dr. Raffy Karamanoukian, MD, FACS · Kare Plastic Surgery, Santa Monica
Surgical Approach
Open Lip Reduction (Cheiloplasty): Step by Step
Dr. Karamanoukian’s silicone lip reduction protocol follows the same rigorous surgical standard he applies to all lip reconstruction cases — with specific modifications for the silicone-infiltrated tissue environment.
Consultation & Diagnostic Assessment
The consultation begins with a complete injection history — what material, when injected, by whom, and how many treatments. A diagnostic hyaluronidase test injection is offered when there is any uncertainty about whether the material is HA or silicone: HA-based overfilling produces visible softening within 30 minutes; silicone does not respond at all. Clinical examination characterizes the lip tissue firmness, scar distribution, vermilion architecture, and symmetry, determining whether one or both lips require reduction and the planned volume of excision.
Local Anesthesia & Incision Design
Silicone lip reduction at Kare Plastic Surgery is performed under local anesthesia — no general anesthesia, no IV, no intubation required. Topical anesthetic is applied first; local anesthetic infiltration follows with a brief 10–20 second sting. Intraoral mucosal incisions are designed along the wet-dry mucosal junction of the upper and/or lower lip, hidden entirely inside the mouth with no visible external scar. The incision location and length are precisely calculated to access the full extent of the silicone deposit while preserving the natural vermilion border contour.
Silicone-Specific Tissue Dissection
The silicone-infiltrated mucosal and submucosal tissue is excised in careful anatomical layers, with meticulous dissection separating the foreign material and its fibrotic capsule from the orbicularis oris muscle fibers below. The silicone-loaded tissue is removed as completely as the adherence to the underlying muscle allows — maximizing cytoreduction while preserving the muscle function that determines post-operative lip movement quality. All excised tissue is sent to pathology for histologic confirmation of silicone foreign body material.
Vermilion Reconstruction & Layered Closure
The reduced lip is closed in anatomical mucosal layers with fine absorbable sutures — no suture removal required. Dr. Karamanoukian’s meticulous attention to vermilion border reconstruction ensures the lip contour, the cupid’s bow architecture, and the normal relationship between the upper and lower lip are restored at closure rather than left to chance healing. The closure technique reflects the same plastic surgery precision he applies to all facial wound closures.
Recovery & Post-Operative Scar Management
Most patients see significant improvement in lip size and natural appearance by 1 week post-operative — as shown in the before/after case above. Final natural result is assessed at 3 months when all swelling has resolved. Post-operative Vbeam laser to any residual firmness or visible redness at the mucosal incision is initiated at 4–6 weeks. Most patients return to normal daily activities within 3–5 days. Soft food diet for 2 weeks. Dental hygiene modifications for 4 weeks.
Why Dr. Karamanoukian
Silicone Lip Reduction: Why the Surgeon’s Expertise Determines Everything
General Lip Reduction Surgeon
- Trained in standard cheiloplasty for congenitally large or HA-overfilled lips
- Limited experience with silicone foreign body tissue — may underestimate complexity
- No silicone disease expertise — cannot assess systemic inflammatory component
- Standard mucosal excision without silicone-specific dissection training
- No post-operative scar laser protocol at same practice
- May recommend hyaluronidase without confirming material type first
✓ Dr. Karamanoukian at Kare — The Standard
- World authority on silicone disease — understands the tissue biology at depth
- UCLA reconstructive lip surgery training + silicone removal expertise combined
- Diagnostic hyaluronidase test confirms material type before any surgical planning
- Silicone-specific dissection from orbicularis oris — function-preserving technique
- Pathology submission on all excised tissue — material type confirmed post-op
- Vbeam laser scar management at same practice — complete post-operative care
Had surgery elsewhere and still unhappy? Dr. Karamanoukian accepts consultation from patients who had lip reduction or silicone removal at another practice and were left with unsatisfactory results, residual firmness, asymmetry, or functional complaints. Second-opinion consultations are welcome. Call (310) 998-5533 or request online at karesurgery.com/contact.
Common Questions
Frequently Asked Questions — Silicone Lip Reduction in Los Angeles
Will hyaluronidase dissolve my overfilled lips?
Only if the overfilling material is a hyaluronic acid filler (Juvederm, Restylane, Versa, or similar HA products). Hyaluronidase has zero effect on liquid silicone, PMMA (Bellafill), Sculptra (poly-L-lactic acid), Radiesse (calcium hydroxylapatite), or any non-HA permanent filler. Many patients presenting to Kare Plastic Surgery for lip reduction have already had hyaluronidase injected multiple times without result — confirming that a permanent, non-HA material is present and that surgical cheiloplasty is the appropriate next step. Dr. Karamanoukian performs a diagnostic hyaluronidase test at consultation when material type is uncertain.
How long does it take to see the final result after silicone lip reduction?
The case above shows the typical timeline: significant improvement in lip size and natural appearance is visible by 1 week post-operatively as the dramatic before-surgery overfilling is eliminated. At 1 week, some post-operative swelling is present — the lips appear meaningfully smaller and more natural but not yet at final volume. By 3 months, all surgical swelling has resolved, the mucosal incisions have fully matured, and the lips show their final natural, proportionate result. Dr. Karamanoukian photographs all patients at consultation, 1 week, 1 month, and 3 months for outcome documentation.
Will silicone lip reduction leave a visible scar?
No — silicone lip reduction at Kare Plastic Surgery is performed entirely through intraoral mucosal incisions placed on the inner surface of the lip. There are no external incisions on the lip surface, vermilion border, or perioral skin. The mucosal incisions are closed with fine absorbable sutures that dissolve without removal. Internal mucosal healing typically produces a nearly imperceptible scar that is not visible with the mouth in any normal position.
Can I get lip filler after silicone lip reduction?
After complete healing at 3–6 months, hyaluronic acid fillers can be introduced to restore subtle lip definition or address any minor volume asymmetry from the healing process. However, re-injecting permanent or long-lasting fillers after silicone removal is strongly discouraged. The tissue environment in a previously silicone-exposed lip will be partially fibrotic, and introducing new permanent material risks a repeat of the overfilling scenario. Dr. Karamanoukian discusses the specific options for any desired volume restoration at the 3-month post-operative follow-up appointment.
Related Resources at Kare Plastic Surgery
Kare Plastic Surgery & Skin Health Center · Santa Monica · Near Beverly Hills
Schedule a Consultation
Schedule a confidential consultation with Dr. Raffy Karamanoukian, a graduate of the UCLA School of Medicine and dual board-certified plastic surgeon — world authority on silicone disease, silicone lip reduction, and lip reconstruction in Los Angeles. National and international patients welcome. Telemedicine available.