Facial plastic surgeon
Fleming Island, FL
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Silicone granulomas and way, way too much volume.
March 9, 2010 6:44 PM
Sorry to hear about your trouble. I looked at your blog and I must say that 1.5ml in an upper lip is a HUGE volume, IMHO. For example, I'll often use 0.8ml TOTAL for upper AND lower lips
Sorry to hear about your trouble. I looked at your blog and I must say that 1.5ml in an upper lip is a HUGE volume, IMHO. For example, I'll often use 0.8ml TOTAL for upper AND lower lips in a younger patient.
The appearance looks suspicious for either silicone granulomas (which are usually treated by excision--cutting them out) or silicone migration. The only FDA-approved silicone in the U.S. is Silikon-1000, but it is NOT approved for any cosmetic use. Silicone--especially when injected in large amounts at once--has a tendency to migrate, too. As for allergies to hyaluronic acid gels, that basically doesn't happen. Yes, there is the almost unheard of allergy to bacterial proteins in NASHA gels (e.g., Restylane, Juvéderm) or to avian proteins (e.g., Hylaform), but HA gels are much safer than silicone injectables. Period.
As for what can be done: probably only excision of some of the product and lip. Achieving a beautiful lip is probably no longer in the realm of possibility, but creating a more normal and less bizarre lip is probably doable. Steroids, antibiotics, and even TNF-alpha inhibitors *may* be a way to avoid excision, but not always.
Good luck, but I'd recommend strongly against any additional permanent filler in a lip such as yours.