Liquid Injectable Silicone and Facial Lipoatrophy
Loss of fat in the face (Facial Lipoatrophy) is part of a larger syndrome
called Lipodystrophy. This is a syndrome that can occur in many disease
states, but is most often seen in HIV-positive individuals who are being
treated with antiretroviral medications (typically protease inhibitors).
This treatment can produce both lipohypertrophy (increased fat deposition)
and lipoatrophy (loss of fat) in various body locations. It is the loss of
fat in the face that typically produces the most concern.
Liquid injectable silicone and the Micro Droplet technique have been used successfully to permanently rebuild tissue in desired sites by stimulating the body’s own collagen production.
The precise mechanism is unknown, but researchers hypothesize that decreased
production of a protein that prevents triglyceride uptake leads to decreased
fat absorption into the cells. Apparently protease inhibitors have a high
affinity for the catalytic site of the HIV virus. Retinoic acid protein and
HIV virus catalytic sites have similar structures to two proteins involved
in lipid metabolism. Fat is unable to be stored or produced leading to high
levels of fat accumulation in the blood. Facial lipoatrophy can be
disfiguring, with the loss of fat from the face leading to a malnourished
look. People with this syndrome feel great, and want their faces to mirror
this healthy feeling.
Silicone is an inert, or non-reactive, substance. It is found in numerous
household products, and is used as a lubricant for medical equipment
including needles and syringes. Medical-grade silicone oil is sterile and
highly purified, requiring no skin testing prior to treatment. Liquid
injectable silicone oil is currently “labeled” for ophthalmologic use.
Although the FDA has not specifically approved the cosmetic use of the
agent, the FDA allows licensed physicians to use these agents “off label” for other purposes, similar to the numerous uses for BOTOXR. With its long
history of safety and a sterile, medical-grade composition, silicone oil is
an excellent filler for most areas of the face. It is currently under
investigation for potential FDA approval in the treatment of HIV-associated
lipoatrophy of the face.
Liquid injectable silicone and the Micro Droplet technique have been used
successfully to permanently rebuild tissue in desired sites by stimulating
the body’s own collagen production. Used for decades in the skin, liquid
silicone oil can be used to fill wrinkles, scars and facial contours that
have been altered by time or trauma.
The Micro Droplet technique involves the injection of tiny drops into the
affected areas in multiple sessions. In much the same way that an oyster
reacts to a grain of sand, the body makes a pearl of collagen around each
droplet of silicone. It does not migrate and rarely if ever produces any
kind of inflammatory reaction. Treatments are conducted at monthly intervals
to allow for collagen rebuilding and a resulting natural appearance.
Multiple sessions are needed and vary depending on the number of sites and
the extent of augmentation needed. The cosmetic use of silicone oil is
compatible with other procedures including lasers and surgery. The Micro
Droplet technique provides a safe, slowly progressive, and very natural
appearing result in all areas of potential treatment. It is less painful
than other fillers and patients can resume their daily activity immediately.
All cosmetic procedures do carry some degree of risk. Possible side effects
include bruising and swelling, overcorrection, discoloration, firm texture,
and an idiosyncratic inflammatory reaction that produces redness and
swelling. Fortunately these reactions are extremely rare; in most instances,
time alone resolves the problems. In other cases, they can be managed with a
variety of procedures including local cortisone injections, removal of
tissue, electrodessication and antibiotics.
Today, the catch phrase in cosmetic surgery and rejuvenation is “have your
cake and eat it, too.” This means that the best rejuvenating therapies offer
significant change with minimal down time. Liquid injectable silicone and
the Microdroplet Technique fit this bill perfectly.
Click here to schedule your consultation with Dr. Resnik
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