LAM FACIAL PLASTICS

Dear Dr. Lam,

I know you are an expert in lip reduction, also after too much silicon was injected by another surgeon. Five years ago I had silicon 1000 injected in both the upper and lower lip (the meaty part and the vermillion border), just a little bit (don't know the cc's unfortunately). I understand you usually don't specifically remove the silicon in itself (since perhaps this is impossible; this is my question actually) but I was wondering if it is possible to specifically remove the injected silicon. My question is why it is impossible to particularly remove the silicon (surrounded by collagen) nodules:
- Is it impossible since the silicon is interwoven into several tissue layers and thus difficult, if not impossible, to specifically locate?
- Is it impossible since it will damage surrounding tissues to cut out the silicon particles?
- Is it impossible since the silicon (surrounded with collagen) nodules migrate out of the meaty part of the lip?


Sorry for these detailed questions but I have several reasons wanting to get the Silicon out (tenderness, sores are started to develop, swollen lips; surgeons I consulted with are in the opinion it's the Silicon) and I'm wondering if there is really no possibility to specifically target the Silicon.

I forgot to thank you upfront for answering my question!

i have cut out scores of silicone lips and in so doing i see exactly into the lip each time. it is always the same, the lip is a grayish color inside and it is a uniform solid matter. there is absolutely no distinguishing between silicone and natural lip. the two are one. i think if i reduce the bulk of whatever you have in your lip that things may help out but obviously i cannot promise you.
best,
sml

Thank you Dr. Lam, very helpful. So if I understand it correctly, to possibly counteract my concerns (tenderness, sores, swelling), the tissue bulk in the lip would have to be cut out as much as possible which would most likely also contain (part of) the Silicon.

My only concern is the fact that I have very thin lips; there was only a little bit of silicon injected. To make sure (hopefully most of) the Sillicon is removed I understand most of the bulk in the lip would have to be removed, which would leave me with 'nothing' I'm afraid, since (even with this bit of Silicon) I have thin lips. Will removing most of the tissue bulk leave me with 'flat lips' and is there a way to counteract this; to inject fat for example? Thanks again.

if you have very thin lips and your lips do not look overinflated i would hesitate to do a lip reduction. that would not be a good option then. i cannot 100% help you with the sores or what you are getting right now. sounds very weird to me. have not seen that. you might think about long term antibiotics like biaxin and 5-FU injections to manage the situation. you may have a low-grade infection of some kind that needs long-term treatments.
best,
sml

Dear Dr. Lam,

is that a common side effect, that the lips even with a microdroplet technique and minimal silikon 1000 (medical grade) are getting inflamed or sore?
How often is that happening? (Assuming a medical grade product and good injection technique).
Thank you. I love your forum.

that really should not happen. you may have some kind of infection and may benefit from long-term antibiotics like biaxin for 6 weeks. i have never encountered it but that is theoretically possible. thanks for the kind words.
best,
sml