Purified Polydimethylsiloxane (Silicone) as Dermal Filler Resolving the Controversy?

Abstract

Dermal fillers are widely used in Medical and Surgical Cosmetic practices. Temporary and semipermanent fillers are more commonly used for a wide variety of reasons; however, permanent fillers represent an excellent option in properly selected patients. The aim of this study is to evaluate the off-label use of Silikon 1000 (S1000) as a permanent filler analyzing safety, durability, and patient satisfaction. This was a retrospective chart review of prospectively collected data. The study included 25 patients who underwent S1000 injection in 32 treatment areas. The following parameters were assessed: age, gender, weight, height, body mass index (BMI), number of treatments, duration of treatments, follow-up, complications, and interventions. Patients who had other fillers injected into the same area within 1 year before or after the S1000 injection were excluded from the study. In all, 32 treatment areas in 25 patients (21 females, 4 males) were included in the study. Five female patients received S1000 in more than one area. Treatment areas included the following: nose (n = 4), lips (n = 16), glabella (n = 4), nasolabial folds (n = 3), scars (acne or others) (n = 2), orbital rim (n = 2), and perioral (n = 1). Extrusion of silicone, migration, cosmetic deformity, hematoma, seroma, and infection were considered as inclusive criteria for injection complications. None of the patients developed any complications along the course of follow-up that ranged from 8-38 months; therefore, no intervention or surgery was needed to treat any adverse outcomes. All patients reported high satisfaction with the cosmetic results. Off-label use of highly purified polydimethylsiloxane as dermal filler is safe and durable. Being conservative is key to optimize outcomes and avoid complications. Proper approach involves injection of small doses using microdroplet technique to augment the tissue gradually over sessions at 1-2 months apart. Complications as silicone migration and irregularities can be largely avoided by following proper techniques and understanding the unique mechanism of action of S1000 compared with traditional fillers.