Plastic Surgery Question of the Week

Each week Dr. Jean Loftus answers selected questions in her Question of the Week column. To submit your question, please follow the link at the bottom of this page.

Q: My wife had silicone injected in her lips 5 years ago and now has painful, lumpy, and hard lips. One doctor told us that the silicone could be removed, and another told us that it could not.

Dr. Loftus Answers: Silicone injection is quite a problem, regardless of where it is injected. At first, it appears soft and wonderful. The early results are usually quite impressive, leading inexperienced plastic surgeons to offer this procedure again and again. I presume that the surgeon who injected your wife was either inexperienced or, more likely, not a real plastic surgeon. Plastic surgeons have known for over a decade that long term results from silicone injection are fraught with problems: inflammation, extrusion, firmness, nodules, irregularities, and pain.

As for the advice you received, both of your plastic surgeons spoke the truth. Their advice, although seemingly contradictory, is accurate. The following analogy may help you understand. Picture a freshly baked chocolate chip cookie with a lot of chocolate chips, some large and some small. If you tried to remove the chips, you would have great difficulty doing so. As you removed each one, you would also remove some of the surrounding cookie. The more chips you removed, the more the cookie would crumble. You would get to the point where you would realize that trying to remove all the chocolate chips would leave you with nothing but crumbs. As with the chocolate chips, some of the silicone can be removed, but trying to remove it all would be impossible without destroying the lip. I therefore advocate removing the most problematic areas.

If plastic surgeons had a way to reconstruct a lip from scratch, then the solution would be to remove the lips and perform a reconstruction. However, this is not possible. Even the best of lip reconstructions fail to look normal. My best advice is to selectively remove the most problematic areas. Later injecting the lip with collagen may help to restore volume, but will be difficult due to scar, inflammation, and distortion. I am terribly sorry for your wife. I wish both you and her the best in getting through this very difficult problem.

Curious about what others have asked? Want more invaluable information on Plastic Surgery? Go to the Question of the Week Archives!

Do you have a question or comment for Dr. Loftus? She'd love to hear from you. Please contact her using this form.

Dr. Jean Loftus is considered a national authority on plastic surgery, and has appeared on CNN, MSNBC, and The Today Show, discussing all facets of cosmetic plastic surgery. The media recognizes her as an ethical, compassionate, and influential surgeon, who maintains patient safety and satisfaction as her top priorities. They know that when they ask Dr. Loftus questions, they will get objective, up-to-date, state-of-the-art information on every area of cosmetic surgery. Dr. Loftus is one of only 100 surgeons in the United States who have achieved double board certification from both the American Board of Plastic Surgery and the American Board of Head and Neck Surgery, a distinction she is very proud of. Her book, The Smart Woman's Guide to Plastic Surgery, is now the #1 best-selling book in the country on plastic surgery.

"I chose plastic surgery because, through it, I can change people in ways they never imagined possible. A change in appearance can transform someone's whole outlook on life. Being a part of this metamorphosis is the most important and pleasurable part of my work" …Dr. Jean M. Loftus

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