Doctors say treating those with silicone is difficult. The only way to get rid of it is to cut out the tissue and surrounding tissue that has been impacted, according to Dr. Patrick J. Byrne, director of the Hopkins Division of Facial Plastic and Reconstructive Surgery, who was not personally involved in the dancer's treatment.

He said that's what he had to do for a patient who came to him this week. She had silicone injected into her lips about 15 years ago, and it had become bumpy between her nose and lips.

Byrne said such injections have always been an "off label" use by FDA standards but were not infrequent 20 to 30 years ago. Doctors are allowed to use drugs approved for one use for something else, but Byrne said it's not common to go that far afield from the approved uses. He knows of no plastic surgeon who would now inject silicone for a cosmetic procedure of any kind.

"To go from a retina to a lip is a leap," he said. "This is why it's important to only have procedures done by board-certified plastic surgeons."

Dr. Larry Lickstein, a plastic surgeon at the Cosmetic Surgery Center of Maryland, said silicone injected in women would have to be removed, a procedure that could leave women looking for fuller backsides with less tissue than when they started. The result could also appear deformed.

He said the procedure recommended now by plastic surgeons to augment a buttock is grafting fat from another place on the body.

Fat can now be harvested from the abdomen, for example, without harming the cells. It can then be purified to remove blood, broken cells and anesthesia and gently distributed within the buttock tissue so that it can form new blood supplies and live permanently, he said.

"You want to limit the inflammatory response," Lickstein said. "There can be significant and severe consequences of cutting corners."

Sun reporter Justin Fenton contributed to this article.

meredith.cohn@baltsun.com

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