Lip Thinning Reversal of Silicone Overcorrected “Trout Pout” Lips
Goals/Purpose:
The expansion of the off label use of medications has been inadvertently expanded to injectables, particularly injectable silicone. Although injectable silicone is currently FDA approved in the United States and available for the treatment of several medical disorders, the off-label statues have allowed unprincipled doctors to override the federal ban. Many have overlooked the volumes of reported side effects of silicone injection such as migration, scarring and granuloma formation. We present the only case series in the literature of the management of previously injected medical-grade liquid silicone for perioral rejuvenation and lip augmentation. We also describe our surgical technique which adequately addresses preservation of a natural aesthetic appearance of the wet and dry lip as well as maintaining the function of the orbicularis oris, all while achieving patient satisfaction.
Methods/Technique:
A retrospective review was performed of 8 patients who were
referred to our practice for management of previously injected liquid silicone for
lip augmentation over a 15 year period. [Figure 1,2,3] A 4-6mm strip of mucosa was
excised starting 1 mm posterior to the mucocutaneous junction, and extending 5
mm past the oral commissure. No
attempt to remove the silicone fibrosis was made. The mucosal edges were closed with a 4-0 chromic suture.
Results/Complications:
Eight patients underwent a mucosal excision after previously
injected medical-grade liquid silicone for perioral rejuvenation and lip
augmentation. No loss of sensation or function was reported and post-operative
healing was ideal without noticeable scarring. All patients were satisfied with their aesthetic result
after surgical management.
Conclusion:
A lip thinning procedure by way of mucosal excision is a realistic approach to address the overcorrected "trout pout" appearance of lips after previously injected medical-grade liquid silicone for perioral rejuvenation and lip augmentation. This technique can be used to minimize further complications as well as achieve patient satisfaction.
