EXPERT ANALYSIS FROM THE AACS ANNUAL MEETING
HOLLYWOOD, FL. (FRONTLINE MEDICAL NEWS) – Less may be more when it comes to liquid silicone for lip enhancement.
Tiny droplets of silicone, placed judiciously and built up gradually, can give a soft, natural, permanent effect, according to Dr. Robert Shumway, president of the American Academy of Cosmetic Surgery.
“Liquid silicone is one of the most awesome fillers you can use, as long as you use it correctly,” said Dr. Shumway at the annual meeting of the American Academy of Cosmetic Surgery. He discussed silicone lip enhancement at the meeting jointly with Dr. Salvador Renteria, his colleague in private practice in La Jolla, Calif.
Using strategically placed microdroplets can produce “permanent, soft, and amazing” results with the correct technique, said Dr. Shumway. The only equipment needed is a 27 gauge needle and a 1 cc syringe, together with the purified liquid silicone material, technically termed polydimethylsiloxane. Silicone is also relatively cost effective for all involved, he said.
Free liquid silicone is only currently approved by the FDA for ophthalmic use, and it’s this formulation that is also used off-label for cosmetic procedures. The fact that cosmetic injection of liquid silicone is off label can present a marketing barrier, and physicians must be careful to adhere to state regulations regarding advertising off-label procedures.
For Dr. Renteria and Dr. Shumway, it also means that a special patient consent form must be used, and carefully reviewed with patients. “We go over this form with them about all the complications that can occur, that it is permanent, that it’s going to require more than one session,” said Dr. Renteria.
The injection technique involves beginning at the lateral commissures and proceeding toward the philtrum in an outline fashion with microdroplets, then adding some volume to the lips after the outline has been enhanced. “In particular, you can augment the philtrum, which gives anterior projection,” said Dr. Renteria. The total amount of liquid silicone injected per session is usually about 0.5 to 0.8 cc, he said.
Managing patient expectations is also important, said Dr. Renteria. “We have a fairly lengthy discussion about what their desires are,” he said.
The interval between injection sessions should be six to eight weeks, and multiple sessions may be required. This interval between treatment sessions allows fibroplasia to occur, so the tissue surrounding the silicone has a similar texture to the injected material. “You’re never going to try to achieve the goal in one session,” said Dr. Shumway.
“Each droplet’s going to grow, which is why you give it 6 to 8 weeks for that growth to occur and encapsulate around each droplet. That’s important, because you don’t get the final result for at least 2 months,” added Dr. Renteria.
Patient compliance with this schedule is essential: “You are the one who has to be in control” of the injection schedule, said Dr. Shumway. “If you’re patient, and your patient is patient, you can get excellent results.”
Dr. Shumway and Dr. Renteria reported no relevant financial disclosures.
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