Silicone Removal and Reconstructive Lip Surgery

Q: Dr. Eppley, I am interested in silicone removal and reconstructive  lip surgery. Could you tell me what would be reasonable and safely doable during surgery at the same time:
1) Get rid of the silicone on the white part of both lips, debulk the philtrum columns that were injected as well with silicone after the lips were injected (this silicone was not injected deep, it’s more on the superficial layer of the skin, but since you is the specialist, I need your advise on this…)
2) Get rid of the silicone bumps and scar tissue I still have on the wet lip inside of both lips.
3) Make upper teeth shown again, since all this bulkiness is weighting down and making my teeth to be hidden. I guess this could be accomplished by removing tissue from the inside, and also making the lip advancement. Lip advancement I guess will be also more appropriate to raise the lip than a lip lift in my case? (since if he has to do an incision there, I think would be more appropriate to raise it from there and not causing a new scar (bull horn)?
4) Re-shape the cupid’s bow, vermilion border and philtrum
5) Re-shape the lower lip, correct the great asymmetry I have (specially on the right side),  make it thinner on the edges and fuller in the middle of the lip. Raise the lip with the V-Y plasty so the lower teeth don’t show that much, since right now I have exactly the way around as it should be (only lower teeth are shown 🙁
6) And he said something about a fat grafting to prevent the scars to become hard and bulky again.
Obviously an in person consultation will be the best, but at least I guess this might help a lot, since I’m showing him also the mucosa inside of both lips. Besides the concern of looking aesthetically much better, I’m concerned about not causing more damage and keep the natural functionality of the lips.

A: ‘I have a very clear understanding of the lip issues due to the silicone material as well as the objectives as has been outlined. I can see the issues very clearly in pictures as well as the Skype consultations. Seeing the lips in person will not change the silicone lip removal and reconstructive surgery plan or, most significantly, what I consider to be the single most important concept to understand about the lip problem and any proposed method to treat it. Trying to remove/debulk and improve the shape of the lips that has been distorted by silicone injections is both very challenging and the results will always be less than desired. There is no completely satisfying solution that will meet all the patient’s aesthetic lip/perioral shape desires. Silicone oil causes permanent damage and shape deformation for which only partial improvement is possible. It is this concept about treating adverse reactions to silicone injected lips that the patient must understand.

Dr. Barry Eppley
Indianapolis, Indiana