LAS VEGAS Complications from liquid silicone injections often occur when the immune system is triggered by a stimulus or an infection, according to a dermatologist with more than 22 years of experience in the use of silicone.
"I would say 80% of problems I see are associated with inflammatory events," said Dr. David Duffy, who practices in Torrance, Calif., and is a clinical faculty member at the University of California, Los Angeles.
The big problem with silicone is that it will interact with infectious processes, including herpes infections, bacterial infections from surgical procedures, or serious dental problems such as large numbers of cavities, he said at the annual meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery.
One patient he saw developed reactions around her silicone injections when she moved into a house that had mold in the basement.
When the mold was cleaned up, her reactions went away. Another patient developed a reaction around her silicone injection when she underwent botulinum toxin treatment, said Dr. Duffy, who did not note any relevant conflicts of interest.
Because reactions seem to be prompted when someone with silicone implants experiences an immune response, Dr. Duffy said that he avoids silicone in patients who have a history of herpes simplex outbreaks, significant dental work, allergies, and a predisposition to sinus infections.
He also does not use silicone in patients who regularly ride motorcycles because they have particulate matter hitting them in the face, and he studiously avoids using it in lips.
Despite its risks, Dr. Duffy does like to use silicone for certain applications, such as revising scars and sometimes nasolabial folds.
The use of silicone for cosmetic procedures has become an issue that is often portrayed as black and white. Either physicians use silicone and like it, or they believe it should never be used. But "I have a long experience with it and I think it is going to remain a routine practice," he said. "I can tell you that in my practice it has revolutionized some people's lives and they aren't spending a fortune on fillers.