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Laser Resurfacing of Silicone-Injected Skin
The "Silicone Flash" Revisited
Warren Zager, MD;
John Huang, MD;
Peter McCue, MD;
David Reiter, MD, DMD
Arch Otolaryngol Head Neck Surg. 2001;127:418-421.
Objective To determine whether prior silicone injection increases the risks associated
with carbon dioxide laser resurfacing.
Design Laboratory determination of the effect of laser energy on liquid silicone;
histologic evaluation of silicone-injected skin after lasing; and histologic
demonstration of silicone deposits in all layers of dermis years after injection
of silicone as filler fluid.
Setting Tertiary care medical center.
Patient-Related Data Histologic examination of freshly excised skin injected with microdroplets
of liquid silicone and subjected to application of carbon dioxide laser energy;
histologic examination of skin excised years after silicone injection.
Interventions High-speed clinical photographic imaging of the effect of laser energy
on silicone fluid; histologic examination of hematoxylin-eosin–stained
sections of skin injected with liquid silicone and subsequently lased.
Main Outcome Measures Response of liquid silicone to application of laser energy; effect of
this response on surrounding normal skin.
Results Exposure of microdroplets of liquid silicone to carbon dioxide laser
energy produced flaring with frank flame. Flaring of dermal silicone caused
collateral skin damage.
Conclusions Prior injection with liquid silicone is a relative contraindication
to cutaneous resurfacing with the carbon dioxide laser. Surgical excision
of silicone-injected skin may be preferable for many patients. A strenuous
needs assessment should be done, alternatives for skin rejuvenation considered,
and comprehensive informed consent obtained from the patient before embarking
on laser resurfacing of silicone-injected skin.
From the Departments of Otolaryngology–Head and Neck Surgery
(Drs Zager, Huang, and Reiter) and Pathology and Laboratory Medicine (Dr McCue),
Jefferson Medical College, Philadelphia, Pa.
Corresponding author and reprints: David Reiter, MD, DMD, Department
of Otolaryngology–Head and Neck Surgery, Jefferson Medical College,
925 Chestnut St, Philadelphia, PA 19107 (e-mail: david.reiter{at}mail.tju.edu).
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Arch Otolaryngol Head Neck Surg. 2001;127(4):470.
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