Three-step Approach for Facial Reconstruction After Injectable Silicon: Surgical Excision, Fat Grafting, and Hyaluronic Acid Filler.

[INTRODUCTION] In facial cosmetic surgery, injectable liquid silicone has been used to augment the cheek and the lips and to camouflage facial wrinkles. However, complications started to arise in 1964 as postoperative silicone granuloma formation. The purpose of this study is to introduce our experience in facial reconstruction after injectable silicon oil with a sequential 3-step approach: transoral surgical excision, full-face fat grafting, and hyaluronic acid filler.

[METHODS] A retrospective study was conducted for all patients affected by facial granulomatosis due to liquid silicone injection who underwent surgical treatment between January 2018 and June 2020 at the Unit of Maxillo-Facial Surgery at the Hospital "Policlinico San Martino" (Genoa, Italy).

[RESULTS] Three female patients completed the entire surgical pathway. The mean age of the patients at the time of surgery was 58.7 years (range, 52-65 y). There was no clinical recurrence of the facial deformity during a mean follow-up of 14 months. Apart from the standard postoperative discomforts such as bruising, edema, and pain, the authors did not observe major complications.

[CONCLUSIONS] Our 3-step approach is a safe and viable option that can be offered to motivated patients affected by granulomatous facial reactions.

[LEVEL OF EVIDENCEBASED MEDICINE EBM] Level 3.