Will Kenalog/5-FU Injections Reduce The Size of a Silicone Granuloma In My Cheeks?

Q: Dr. Eppley,  I am a transgendered MTF and had botched silicone injections in my face in the cheeks years ago.  Over the years it has enlarged especially my right side.  Will 5-FU/kenalog shots work to bring down this very noticeable mass in my cheeks?  How much are each shot? 

A: I am assuming that this cheek mass is reactive scar tissue to the injected silicone. Unlike conventional scar tissue, this would represent a comglomerate of fibrous tissue (scar) and silicone oil rather than just scar tissue alone. While kenalog or combined kenalog/5-FU injections may help soften the scar tissue which contains the silicone droplets, it will obviously not get rid of the molecularly-stable silicone. The key question is then will scar injections reduce and soften the cheek mass that you have? That is an unknown question that no one can predict. Despite the unpredictability of the outcome, I see no downside to doing so. It is a simple and relatively inexpensive treatment ($225/injection session) to do, Positive results could be expected to be seen in three to six weeks after treatment. Whether more than on session would be needed would be based on the response to the first set of injections.

Dr. Barry Eppley

Indianapolis, Indiana