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Silicone for Facial Lipoatrophy

Jul 18, 2014

I have been HIV positive since the early 80's. I'm doing well, but the effects of multiple HIV drugs have taken their toll on my face (as has aging). I am considering having some augmentation done. I have previously had Sculptra injections. However, my dermatologist has recommended Silikon (micro droplet silicone oil using Silikon 1000) as treatment due to the amount of lipoatrophy. What are your thoughts? Safe? Effective? Would it cause other complications?

Response from Dr. Pierone

Hello, thanks for posting.

Silicone has acquired a bad reputation for use in facial filling and volume augmentation. Many of the negative outcomes have been driven by unqualified injectors using poor technique.

There are a limited number of physicians who perform micro-droplet silicone injections for facial augmentation and have demonstrated excellent results. I have never performed silicone injections, but I have treated several dozen patients who previously had silicone injections. The great majority had very good results from the silicone injections with many years of durable benefit. A minority of these patients had poor outcomes from the silicone. I have seen visible nodules or visible linear dermal thickening that was probably related to improper injection of silicone into the superficial dermis. I have also seen patients who simply were over-treated and ended up with cheeks or lips too large and out of proportion for their face.

I would say that micro-droplet silicone is generally safe and effective. The poor outcomes that I have seen appeared to have based on injector error or inexperience as best I could determine.

My personal view is that Artefill (PMMA + bovine collagen) is a better option and produces better long-term outcomes. But it is quite expensive due to the volume needed to treatment significant facial lipoatrophy.

I hope this information helps and good luck!

Complications of plastic surgery for atrophy
sculptra and medicare

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