Industrial Liquid Silicone in the Face: Risks and Care

Every HOF professional, sooner or later, sees someone who has liquid silicone in their face. It may be a patient who had it done decades ago, when "it was what there was"; a patient who was injected with a product they do not even know; or a person thinking of having it done somewhere with no oversight. Industrial liquid silicone is one of the most serious causes of late complications in facial aesthetics, and knowing how to recognize and manage these cases makes a difference.

This page is a review for the HOF professional. It covers what is known about complications, patient care and referral. It does not describe removal techniques or recommend a specific treatment: that is a decision for an experienced team, according to the rules of their professional council (in Brazil).

What is industrial liquid silicone and why is it different?

Silicone used industrially, as a lubricant and for other purposes, is not a product developed to be injected into humans. Not every substance with "silicone" in its name is the same: there are silicone materials approved in medical devices, such as implants, which follow their own manufacturing and control processes. The problem is the liquid product of uncertain origin and purity, injected as a filler.

A few characteristics explain the risk:

• Permanence. The body does not reabsorb the material.
• Mobility. Being liquid, it can shift over time, through gravity and facial movement.
• Body response. The tissue reacts to the foreign body, sometimes chronically and excessively.
• No reversal. No enzyme undoes it, unlike hyaluronic acid.

Which complications are described?

Complications can appear early or much later. Most clinical reports describe late reactions, years after injection. The table organizes the main presentations at review level.

In severe cases, pain, functional limitation and emotional impact are significant. Support, without judgment or blame, is part of the care.

Why is removal difficult?

The main difficulty is that the material disperses in the tissue, infiltrating between fibers and surrounded by an inflammatory reaction. Removing all of it is usually impossible, and trying for complete removal can cause more damage than the material itself. That is why the approaches discussed in the literature are individualized and generally aim to control inflammation, treat the most problematic nodules and, in selected cases, surgically remove portions, accepting a partial result.

These decisions belong to teams experienced in complications from permanent material, usually involving plastic surgery, dermatology and, when needed, other specialties. For the HOF professional, the role is to recognize, not make it worse, document and refer.

How do you assess a suspicion?

Many patients do not know what was injected. Some clues may suggest permanent material or material of unknown origin:

• A history of a very old filler, done outside a health setting or by someone without training.
• Large volumes injected at once, in the lips, cheekbones, chin or buttocks, or several cheap sessions.
• Hardening, nodules or a "beaded" look over time.
• Intermittent swelling with no apparent cause.
• Material that does not respond to hyaluronidase when the professional suspects hyaluronic acid.

See the more general reasoning on the page patient with unknown previous filler and in permanent fillers: what is known. For imaging, referral to a service with ultrasound and experience helps map the material, but the indication is up to the responsible physician.

How do you talk to the patient?

Silicone carries shame and guilt. Many patients fear being judged and losing the team's trust. Support is the first step. Then comes honest information: what is known, what is not, what the procedure can and cannot solve, and who can help. Avoid promising reversal and avoid disparaging whoever injected it.

The page I already had it done and did not like it has a script for this kind of conversation. For complications, the text on telling the patient about a complication helps organize the words.

Prevention: how to advise someone considering it

Part of the professional's job is to inform. Anyone who seeks a cheap filler, in a setting with no infrastructure and with an unregistered product, is exposed to risk. A few practical tips:

• Check the product's registration with Anvisa (Brazil's health regulator). The page how to check an injectable's registration with Anvisa shows how.
• Be wary of prices far below market, "imported product with no invoice" and promises of permanent results.
• Require a qualified professional, a suitable setting and informed consent.
• Keep the card of the injected product, with lot and expiry.

Without naming names, you can tell the patient that choosing the place is part of safety. See also injectable traceability.

Records and communication

Record in the patient record the reported history, findings, photos, guidance given, referral and follow-up. If there is a serious health complaint, consider reporting the event; the path is in adverse event reporting in Notivisa (Anvisa's reporting system). If you refer, note the name of the service or professional and the date.

How Harmy fits into the conversation

Harmy generates a projection from a frontal photo. In a patient with suspected permanent material, the simulation should not be used to propose new volume in the affected area. But it can help discuss healthy areas, always after specialist assessment.

Takeaways

Industrial liquid silicone is an unregistered, permanent, irreversible filler associated with serious, late complications. Always ask about the history, do not inject into the area, support without judging, document and refer to an experienced team. For prevention, inform patients about product registration, a safe setting and traceability.