Liquid Injectable Silicone: A Review of Its History, Immunology, Technical Considerations, Complications, and Potential

Abstract

For over five decades, liquid injectable silicone has been used for soft-tissue augmentation. Its use has engendered polarized reactions from the public and from physicians. Adherents of this product tout its inert chemical structure, ease of use, and low cost. Opponents of silicone cite the many reports of complications, including granulomas, pneumonitis, and disfiguring nodules that are usually the result of large-volume injection and/or industrial grade or adulterated material. Unfortunately, as recently as 2006, reports in The New England Journal of Medicine and The New York Times failed to distinguish between the use of medical grade silicone injected by physicians trained in the microdroplet technique and the use of large volumes of industrial grade products injected by unlicensed or unskilled practitioners. This review separates these two markedly different procedures. In addition, it provides an overview of the chemical structure of liquid injectable silicone, the immunology of silicone reactions within the body, treatment for cosmetic improvement including human immunodeficiency virus lipoatrophy, technical considerations for its injection, complications seen following injections, and some considerations of the future for silicone soft-tissue augmentation.

Ecografía de los materiales de relleno inyectables y su interés en el seguimiento diagnóstico

“…Por todo ello, pensamos que la práctica sistemática de la ecografía aplicada al estudio, seguimiento y comportamiento de los materiales de relleno inyectables posee un indudable interés clínico (14); sin olvidar que la anamnesis y la exploración clínica complementan y precisan de modo adecuado la información ecográfica. Por otra parte, la clasificación en patrones ecográficos es interesante de cara a decidir sobre la conveniencia o no de una evacuación del material inyectado, sobre todo en aquellos materiales que presentan patrón vacuolar; es posible su evacuación ecodirigida cuando son causa de problemas.…”

Estudio clínico de eficacia, duración y efectos adversos del implante de ácido hialurónico en área buco-maxilo-facial

“…Although the literature suggests numerous materials (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) for increasing the volume of soft tissues, HA (1-6,10-17,20-52) , silicone (1,5,(53)(54) , polylactic acid (5,12,(55)(56)(57)(58)(59)(60)(61) , autologous fat (1,5,12,(62)(63)(64) , collagen (1,5,12,(65)(66)(67)(68)(69)(70) , Ca hydroxyapatite (1,5,12,(71)(72)(73)…”

Intradermal fillers for minimally invasive treatment of facial aging

“…[63] Injectable silicone oils for augmentation of the facial tissues were approved by the FDA in the early 1960s. [64] In spite of the tremendous criticism that silicone has received due to its adverse complications, it has been shown to be very effective in facial augmentation. [64] A clinical study conducted by Hevia [65] demonstrated the efficacy of silicone oil in soft tissue augmentation.…”

“…[64] In spite of the tremendous criticism that silicone has received due to its adverse complications, it has been shown to be very effective in facial augmentation. [64] A clinical study conducted by Hevia [65] demonstrated the efficacy of silicone oil in soft tissue augmentation. In total 916 patients were treated with PDMS-1000 (purified polydimethylsiloxane), an FDA approved silicone oil, over a six year period during which only 1% showed adverse granulomatous reactions.…”

“…[65] All treatments were performed with a serial puncture technique, which is well-suited for the injection of silicone oil. [65] Narins and Beer [64] note that the oil must be injected into the immediate subdermal plane or deeper to avoid dermal erythema and ridging. The volume should be limited to no more than 0.5 mL for small areas including the nasolabial fold, and 2.0 mL for larger areas as seen in facial lipoatrophy.…”