Saturday, February 13, 2016

Microdroplets of silicone

Dr. David Orentreich. “We all have small amounts of silicone in our bodies,” reveals Dr. Orentreich. That’s because silicone is used in many products and devices. For example, it is used as a lubricant in the medical industry coating disposable needles and the inside of IV bags. “Tiny molecules of silicone stick around every time you get a shot,” he explains. Known as polydimethylsiloxane and dimethicone, silicone is used in a wide variety of grooming products too including shampoos and face primers.
by Delia von Neuschatz

I recently met up with a friend – let’s call her Brenda – who takes very good care of herself. This is especially true when it comes to her beauty regimen. When I say that no pore has been left unturned and no hair left to its own devices, I am not exaggerating. Extremely particular about every one of her treatment providers, Brenda looks far and wide before settling on a manicurist, masseuse, facialist, hairdresser and dermatologist – especially dermatologist. She’s no stranger to Botox and microdermabrasion and even though she likes to tweak and fine tune things on a regular basis, she does not look overdone. In her late 30s, she just looks like she stopped the clock a good five years or so ago.

While I knew that her smooth and rested complexion was not entirely the work of mother nature, I was surprised to discover that Brenda had had her lips augmented. I would never had guessed she had used fillers there because her lips, to my eye, looked entirely natural – full, but not too full and in proportion to her face. There was no pout or puffiness. The secret, she revealed, was microdroplets of silicone.

“Hang on!” I said. “Isn’t silicone permanent ... and also scary given the potential complications?” “It’s permanent and it’s great,” she said. “Go talk to Dr. Orentreich.” So off I went to see Brenda’s dermatologist, Dr. David Orentreich, at his Fifth Avenue office to get the lowdown.
Silikon 1000 is the purified silicone that is used as a cosmetic filler. It is chemically inert and thus remains a liquid after injection. It is not altered or changed by the body. Because it is sterile and non-allergic, no test injection is required.
A drop of Silikon 1000. The 1000 refers to the viscosity of the silicone. A value of 1000 means that it is 1000 times thicker than water. “It’s like molasses,” says Dr. Orentreich. The microdroplet technique calls for only one- to two-tenths of a teaspoon of silicone per treatment.
Medical-grade liquid injectable silicone (LIS) is a thick, clear, highly purified man-made oil. Originally developed by opthalmologists to treat detached retinas, LIS, aka Silikon 1000, has been used off-label to smooth acne scars, soften furrows and plump up cheeks, lips, temples and hands since it received FDA approval in 1997.
Before and after pictures of one of Dr. Orentreich’s patients. After the silicone microdroplet procedure, the lips are fuller and the lines radiating from the lips are softer. The frown line has disappeared and the naso-labial folds are smoother.
Doctors use a microdroplet technique whereby LIS is injected into the skin at multiple points using a slender needle. Over a period of months, the silicone stimulates skin cells to produce new collagen around each microdroplet, thereby bulking up the skin. “The way you do it is you under-treat the area,” says Dr. Orentreich, whose father, renowned dermatologist, Dr. Norman Orentreich, pioneered the use of tiny amounts of silicone to fill facial wrinkles back in the 1950s. “Then you wait a few months to see how the area has filled.”
Dr. David Orentreich’s father, celebrated dermatologist Norman Orentreich, giving Truman Capote a chemical peel. The photo was taken by Andy Warhol. Dr. Norman Orentreich, who counted many famous faces among his patients including Cary Grant and Elizabeth Taylor was a pioneer in his field. In addition to his early work with silicone injections, he performed the first modern, successful hair transplants, patented the Buf-Puf and developed the Clinique product line, the first dermatologist-guided, allergy tested, 100% fragrance-free cosmetic brand.
But what about the potential negative side effects such as permanent sores or lumps and even migration of the silicone? Drift of LIS is rare and occurs only after large volumes are injected. It does not occur with the microdroplet technique, according to Dr. Orentreich. And, foreign-body reactions have taken place only after injection of adulterated liquid silicone. Some practitioners, explains Dr. Orentreich, had misguidedly mixed liquid silicone with oils (such as olive, sesame or mineral oil) in the mistaken belief that the combination would improve results. By contrast, foreign-body reactions do not occur when using only pure, sterile LIS.
Dr. Rhoda Narins: “When administered correctly, silicone is a superior product that gives you fabulous results.”
Dr. Rhoda Narins, who has been treating patients with silicone since 1998, says she has never seen a problem. “Most of the past problems were caused by adulterated silicone or by over-treatment. Under-treatment is the key,” she concurs. “When used correctly [i.e. spacing treatments 4- 8 weeks apart] you would never know a person has had anything done.”
Before and after photos of one of Dr. Narins’ patients whose had her lips augmented with silicone.
So, who’s a good candidate for this procedure? Dr. Narins likes administering LIS to younger patients because they need less treatment. But “older patients have more impressive results as they have more to improve,” she says. Dr. Narins also likes what silicone does to the lips, giving them a bit of structure without making them puffy. (But, she recommends getting no more than three treatments for the lips.) And, “nothing is better for acne scarring,” she affirms.
Acne scarring treated with microdroplets of silicone.
Today, however, there’s a large selection of available fillers with long-lasting results and LIS is not for everyone. The bottom line when it comes to this treatment is that “you have to go to a doctor who uses good judgment and who can say ‘NO,’” says Dr. Narins.

As for costs, expect to pay in the neighborhood of $800 per treatment which is less than what a syringe of other fillers such as Restylane will run you. It’s also less expensive in the long run because it’s permanent. An added benefit is that you’ll never walk out of a doctor’s office with newly plump features as it’ll be a month or two before the results of LIS injections will become apparent. The changes are very gradual so detection is less likely.

Should I decide to resort to fillers in the future, I would definitely consider silicone, an option I would have rejected outright a short time ago. I am glad Brenda is generous with her beauty secrets.
Expert Tip: Use a temporary filler in the treatment area first to gauge the results before taking the plunge with silicone, advises Dr. Orentreich.
For more beauty tips and information, follow Delia on Instagram: @chasingbeautywithdvn.