Q: Dr. Eppley, I have a facial scar below my left cheek that I want revised by a geometric broken closure. One question I have is that I had Silikon 1000 injected under the scar to try and raise it several years ago. The material has migrated around the scar making the scar look even more indented as the surrounded tissue is raised. So I know the scar I have is around 2.2cm but I’m not sure how wide it is including the surrounding skin. Would you be able to remove the Silikon 1000 filler or at least the raised skin around the scar? If so could you still do geometric broken line excision or would you have to do a straight line scar. I REALLY want to get rid of this Silikon 1000 but not if it leaves me looking like one side of my face is way thinner or not symmetrical to the other side. What would be your advice with this? Warm regards.
A: Once silicone oil droplets are in the tissues there is no way to get it out unless it is part of the actual scar revision. I would treat the fact that there is silicone in the tissues as irrelevant. It would not change how I would do the scar revision or the amount of tissue removed. Trying to go beyond the actual scar borders in an effort to achieve the ancillary goal of silicone material excision is fraught with causing additional scar problems. It is best to treat the scar as if it was not there.
Dr. Barry Eppley