Everything old is new again. One would think that with all the new fangled wrinkle fillers showing up on both sides of the pond, that a substance first used in Japan in the 1940’s would be considered ancient history in these modern high tech times.
Medical-grade silicone is a synthetic or man-made polymer that has been used in numerous medical applications in its solid form for decades. Liquid Injectable Silicone, called “LIS” for short, is a crystal clear, thick glop. In the 1950s Dr. Orentreich pioneered the use of tiny amounts of silicone to fill facial wrinkles and plump lips. It took the U.S. by storm in the in the 1970s and 1980s when a bevy of upper east side socialites were popping into the famous Dr. Norman Orentreich’s clinic overlooking Central Park on Fifth Avenue for silicone shots every month or so like clockwork. In those days, there was nothing else around. Zyderm® or cow collagen did not come onto the scene until 1981, and Restylane® did not arrive til the mid 1990s. No one had even conceived of injecting botulism into their wrinkles yet. I can recall many fashionable New York women showing up at galas and openings back in the day with little horizontal beading running across their high and non-botoxed foreheads where silicone droplets had lodged. It was not pretty.
The technique used today involves microdroplets of silicone that build soft-tissue by encouraging the production of new collagen, the skin’s natural structural protein. Think of the proverbial grain of sand and the oyster. The body forms collagen layers around the silicone drop (like the sand) and augmentation is achieved by the formation of scar tissue. Silicone injections are used primarily to fill wrinkles, acne and chicken pox scars, and they can also enhance lip contours and cheekbones, and to treat defects that result from trauma. Critics cite the possibility of the silicone migrating inside the face as reason enough to stay away from it. So many mistakes have been done in the past using silicone that it has gone out of favour. The most common issue has been injecting an excessive amount which can dislocate and migrate. Gravity also changes your face as time marches on, so permanent fillers do come with limitations.
In 1998, the FDA acknowledged that liquid silicone may be used legally as a medical device in America, although it is not specifically approved for lines, lips and wrinkles or any other injectable cosmetic uses. Currently, the only permanent injectable filler approved by the FDA is ArteFill, and the company closed its doors at the end of 2008. So currently, the only permanent filler available in the US is off-label liquid injectable silicone.
Silicone injections have been tainted in the past, mainly because of the non-pharmaceutical grade being used in back rooms and dodgy salons. Several forms of non-sterile, non-medical grade silicone oil, not intended for human use, can be purchased through industrial suppliers and via the Internet. The silicone controversy was reignited after the unfortunate demise of a 23 year old transgender person from illegal silicone injections in Albany, Georgia in 2004. The silicone used on the black market is similar to the sealants found in hardware or DIY stores. That silicone is neither sterile nor pure, which can cause infections, and is often mixed with baby oil and other substances.
Silicone is surprisingly affordable when compared with other wrinkle fillers. Each treatment costs about $500. However, the list of possible side effects can be daunting and includes discoloration in thin skin, hard nodules, and inflammatory reactions that produce redness and swelling. If it does go wrong, the only way to remove it is with surgery. Complications from silicone injections can be worse than with other fillers, even with the microdroplet technique. It is important to only use small amounts per treatment session because it is permanent, and you will want to avoid lumps and bumps, which are permanent too. The incidence of problems with silicone is usually related to poor technique, or using too much, which is why seeking out an experienced silicone injector is so critical if you are keen to try it.
Just like diamonds are forever, after approximately three treatments you won’t have to go back every few months for more. This may seem like a real advantage to some, until little beads or hard spots show up.