Dr. Sam Lam Plastic Surgery Forum

Dr Lam, Do you think it is possible to correct some shallow-ish rolling scars in the temple region with microdroplet silicone? I have read that intra dermal injections are possible with an experienced practitioner. Do you think it is safe to inject intra dermal in this area with silicone? Thank you ,Nick

1. temple corrections are safe in the right hands. i do them all the time.
2. very shallow corrections may not be safe if they are in fact dermal etches. basically, "intradermal" injections are completely dangerous. all silicone must be injected subcutaneous.
best,
sml

Thank you Dr Lam, what would you classify as dermal etchings? The scars i currently have can be raised with filler as i have previously had Resty injected into them. Would these scars possibly be helped by Micro silicone? I was also thinking that when the silicone is injected beneath the dermis, wouldn't there be inevitably be some tracking of the silicone into the dermis as the needle is removed? would this be a cause for concern? Thanks again .Nick

1. dermal etches are the very superficial "cut marks" into the dermis. a deeper loss of volume there like rolling deformities are treatable with silicone.
2. no tracking if it is done right.

I notice that this is an old thread, but I had a few questions along the same lines.

First, is there something about the way silicone micro-droplets work that make them less likely than Restylane/Juvederm to produce a "donut" effect around scars? It's my understanding that a lot of it depends on the skill of the physician doing the injecting, but is there something about the silicone itself that makes it less susceptible to donutting than Restylane and other fillers?

you are right. almost everything is injector dependent. i would say the #1 variable is the injector, then the product. the reason that i believe silicone donuts a lot less is that it is placed in little droplets into the scar tissue effectively raising the entire bed of scar slowly. restylane is placed as a bolus meaning that i can go around the scar.

I have seen several examples of successful acne scar treatments with silicone... it is very inspiring to finally see a treatment that appears to be giving significant results to people.

Also, you had mentioned that silicone shouldn't be injected too shallow... but are there any fillers (maybe Evolence?)that are able to be injected more superficially for scars that may not be as deep (but are nonetheless still very apparent in adverse lighting)?

yes, that is correct. as far as my colleagues are concerned (just got back from vegas), they have not been that impressed with evolence. one trusted colleague said, "Sam, you want to buy all my evolence?" i like the expression don't be the first person on the block doing something or the last one. i have not tried evolence and have no intention at this time. if you find someone that can get you a result with it and you trust, go for it.
best,
sml