Dermal Fillers
Permanent Silicone Filler
Liquid injectable silicone (LIS) / PDMS
Permanent, irreversible filler with high late-complication rates, avoid
Silicone filler risks -- granuloma formation, migration, and permanent disfigurement -- are not Fitzpatrick-dependent. This procedure is contraindicated for all patients regardless of skin tone. Skin type is not the relevant safety variable here; the permanent irreversibility is.
Permanent liquid silicone injected under the skin. Not FDA-approved for faces. No antidote exists. It cannot be removed. Complications including lumps, inflammation, and permanent disfigurement can appear years after injection and become progressively worse. This is categorically different from hyaluronic acid fillers, which dissolve safely with hyaluronidase. Under no circumstances should you accept this treatment regardless of how it is presented or priced.
Liquid injectable silicone (polydimethylsiloxane, PDMS) is a permanent, synthetic, non-biodegradable filler not FDA-approved for soft tissue facial augmentation. Despite this, it has been used off-label for decades. The fundamental clinical problem is irreversibility: silicone is encapsulated by fibrous tissue but is not absorbed or cleared by the body. Late complications including granuloma formation, migration, and chronic inflammation are well-documented in case series beginning years after injection. There is no agent that dissolves or neutralises injected silicone; surgical removal causes scarring and cannot achieve complete clearance.
- ✓
Granuloma formation documented in case series years post-injection; no reliable removal technique exists.
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Migration of injected silicone documented in imaging studies; material can move to unintended anatomical sites.
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The FDA explicitly does not approve liquid injectable silicone for soft tissue facial augmentation regardless of silicone grade.
- ?
Nothing -- permanent risk with no reversibility means there is no ethical basis for further cosmetic RCT development of this product.
Late complications of injectable liquid silicone: a series of 21 cases
Zappi & Barnhill · Dermatologic Surgery · 1994
Case series documenting delayed granuloma formation, chronic inflammation, silicone migration, and permanent facial disfigurement in patients who received injectable liquid silicone years prior. There is no safe method to remove injected silicone; surgical excision causes scarring and cannot achieve complete removal. Hyaluronidase has no effect.
PubMed ↗ PMID 8161792| Brand | Manufacturer | What differentiates it | Approval | Pricing |
|---|---|---|---|---|
| Silikon-1000 | Various | FDA-approved for retinal tamponade in eye surgery ONLY; sometimes misused off-label for face -- do not accept | FDA eye surgery only | Varies |
| Bioplastique | Various | Silicone microspheres; CE-marked for some uses in EU; not standard of care and carries same long-term risks | CE (limited) | Varies |
| Bellafill | Suneva Medical | PMMA microspheres in collagen; the only semi-permanent filler that is FDA-approved; still carries late granuloma risk unlike HA fillers | 2006 | $800-1,500/syringe |
Should You Try This?
Probably don't do it
Clinic checklist
Universal
- Check the practitioner is licensed and registered. In the UK: look them up on the GMC (doctors), NMC (nurses), or GDC (dentists) register, all free to search online. In the US: search your state medical board. Takes 2 minutes. If they cannot tell you their regulatory body, leave.
- Ask to see the product box before treatment. It should be factory-sealed with a visible lot number and expiry date. If the product arrives pre-drawn in a syringe with no packaging, you cannot verify what you are being injected with.
- You should receive a written consent form before treatment. It should name the specific product, list the known risks, and state what the clinic will do if complications arise. A single generic form with no product name is not adequate.
- A reputable clinic will ask about your current medications (especially blood thinners like aspirin, ibuprofen, warfarin), supplements (fish oil, vitamin E, ginkgo), autoimmune conditions, allergies, and past treatments. If no one asks, they are skipping a safety step.
- Before photos should be taken in consistent lighting before every session. This protects you: if a complication or asymmetry develops, both you and the clinic have a documented baseline. If a clinic does not take before photos, they are not tracking outcomes.
- Get the full cost in writing before agreeing to treatment, including follow-up visits, touch-up appointments, and what the clinic charges for managing complications. Verbal quotes are not binding.
Procedure-specific
- Do not accept this treatment under any circumstances.
- If a practitioner offers liquid injectable silicone for the face, leave the clinic.
- No legitimate indication exists for this procedure in cosmetic facial practice.
- Seek HA-based temporary fillers instead; these are fully reversible with hyaluronidase if complications arise.
Educational content only. This page summarises published clinical research and is not medical advice. Consult a qualified healthcare provider before making decisions about your care.