For more than fifty years, liquid injectable silicone has been used for soft-tissue augmentation, drawing polarized reactions from both the public and from physicians. While many doctors consider silicone too risky for facial cosmetic injections (and it is not FDA-approved for this use), there are doctors who use it legally (and successfully, they say) as an off-label use.
The Arguments Against Cosmetic Silicone Injections
Although it has not been established that silicone causes any systemic disease, numerous studies have shown that silicone may be potentially problematic. Migration (movement away from the intended site) is a possibility, and localized inflammation can present issues of its own, including exerting pressure on nearby nerves, which can affect sensation and movement of the facial muscles.
Furthermore, the quality sometimes touted as silicone’s main advantage -- its permanence -- is also possibly its biggest liability. If things go wrong, liquid silicone is impossible to remove without causing significant (often disfiguring) damage to the surrounding tissue.
The Arguments In Favor of Cosmetic Silicone Injections
On the other hand, proponents of silicone use point to its inert chemical structure, ease of use, long-lasting results, and low cost as advantages over other available injectable fillers. They say that liquid silicone injections have been successfully used for decades in applications like the filling of acne scars, improvement of facial areas affected by AIDS-induced lipoatrophy, and even non-surgical rhinoplasty.
Another popular argument put forth in favor of the use of liquid silicone injections for soft tissue augmentation is that while not FDA-approved for facial injections, liquid silicone is approved for injection into the eyeball to treat a detached retina, and as a lubricant for hypodermic needles. Technically, liquid silicone is being introduced in tiny amounts every time anyone receives an injection of any kind.
Silicone advocates emphasize that most notable complications are usually the result of large-volume injection and/or industrial grade, counterfeit, or adulterated material. They are quick to point out that many reports in the media (and even in some respected medical journals) fail to distinguish between the injection of medical grade silicone injected by well-trained physicians using the microdroplet technique and the injection of large volumes of industrial grade products by unlicensed or unskilled practitioners.
Where Everyone Agrees
It is important to note here that both opponents and proponents agree that there are certain practices which are categorically unsafe and should never be attempted with liquid silicone. The first is the injection of large volumes of liquid silicone to augment body parts such as the breasts, calves, and buttocks. This dangerous and disfiguring trend has been unfortunately associated with the transsexual community and an activity called “pumping” or “plumping” parties.
This brings us to the second major silicone “no-no” -- self-injection of industrial (not medical) grade silicone, or injection by the unlicensed and inexperienced practitioners who offer these parties. The dangers of this practice received worldwide attention in March 2007 with the sensational celebrity-news story about “Priscilla Presley and Dr. Jiffy Lube.” These types of practices invariably lead to unsatisfactory (and often disastrous) results.
Want to Learn More About Silicone?
For more information about the many uses of silicone in plastic surgery, including safety information, read The Truth About Silicone.
Interview with Robert Kotler, MD, FACS, facial cosmetic surgeon in private practice, author of Secrets of a Beverly Hills Cosmetic Surgeon; Beverly Hills, CA, conducted on August 31, 2009
Liquid Injectable Silicone: A Review of Its History, Immunology, Technical Considerations, Complications, and Potential; Narins RS, Beer K.; Plast Reconstr Surg. 2006 Sep;118(3 Suppl):77S-84S
Liquid Injectable Silicone for Soft Tissue Augmentation; Prather CL, Jones DH; Dermatol Ther. 2006 May-Jun;19(3):159-68
Workshop on Innovative Systems for Delivery of Drugs and Biologics: Scientific, Clinical, and Regulatory Challenges; United States of America Food and Drug Administration; July 8, 2003