SPECIAL TOPIC The History of Injectable Silicone Fluids for Soft-Tissue Augmentation

Background: The debate over the legitimacy of silicone as a safe tool for soft-tissue augmentation has spanned well over half a century. Proponents concede that injections of questionable purity and/or of massive quantities have pro-duced unfavorable outcomes. They assert that in experienced hands with “in-jectable-grade ” silicone, there are very few problems. Despite these claims, the literature is replete with disastrous outcomes following silicone fluid injection, often many years after the initial treatment. Methods: An extensive review of the English-language literature was conducted using MEDLINE. Results: A comprehensive review of injectable silicones was completed, reveal-ing the origins, misuses, early clinical trials, and support for and against the injection of silicone fluids for the augmentation of soft tissues. Conclusions: A better understanding of the history of injectable silicone fluids for soft-tissue augmentation can give insight into the pitfalls and complications surrounding its use. There has been an evolution in the technique and type of products used for soft-tissue augmentation. In its current use, silicone oil for permanent soft-tissue augmentation could be a very powerful tool. There is some literature that supports the use of a small amount of purified, high-viscosity silicone oil; however, there has not been a single longitudinal study to date with appropriate follow-up data. The unanswered question remains: Are the risks worth the potential benefits of silicone oil as a permanent filler? (Plast. Re-constr. Surg. 120: 2034, 2007.) BEGINNINGS OF SILICONE The Swedish chemist Johann Berzelius was thefirst to isolate elemental silicon in 1824. F. S.Kipping at Nottingham University first syn-thesized silicone in the late 1800s using the new Grignard reagent. This method of producing or-ganosilicones is still in use today. He was primarily interested in the pure chemistry of silicones, not their applications. He described the silicone poly-mers as sticky messes that had no uses and called them “uninviting glues. ” From 1899 to 1944, he published 54 articles on the subject of silicon-carbon chemistry. The first polydimethylsiloxanes were first made in the late 1930s by Frank Hyde, an organic chemist working with Corning Glas