The Use of Injectable Silicone Microdroplets to Improve Small Facial Defects and Imperfections in the Nose

Abstract

Introduction: After rhinoplasty, an imperfection often becomes apparent after healing. Such imperfections usually present as a depression that can be corrected using a serial puncture technique with the injection of sequential microdroplets of silicone. The injection technique, results, and minor complications are presented. Materials and Methods: The technique using microdroplets of 1000-centistoke silicone injected through a 30-gauge needle into depressions around the nose is presented. Seven patients are chosen to illustrate the procedure. Results: Preinjection and postinjection photographs demonstrate the degree of correction of minor imperfections without adverse tissue reactions. Discussion: Silicone offers a safe and easier alternative to saving a patient's own cartilage for use as filler material. Storing cartilage requires a refrigerated germicidal solution and a tissue bank license. Using a serial puncture technique with the injection of microdroplets of silicone is an easier and more rapid method of correction than performing surgery again and implanting cartilage or other solid filler material. Although silicone is not absolutely inert, it elicits less physiological activity than any other foreign substance known today. It is indestructible and nonallergenic; it is never metabolized; it does not support bacterial growth; and no immunologic diseases have been associated with it. The eventual response to its injection is fibrosis resulting in slightly increased collagen deposition localized to the immediate surrounding area. The fibrosis is self-limited and does not become extensive. Conclusion: When properly used, pure liquid silicone ranks as one of the most remarkable substances to emerge in the field of cosmetic surgery. In this author's opinion, it is the “gold standard” of all injectables. This modality is inexpensive with no downtime, it is an office procedure that is rapid with minimal discomfort, and it is extremely safe.