New Haven Dermatologists

Discoloration of Skin in Area of Injections - Botox & Juvederm Combination

8 weeks ago I had my 1st treatment.Botox with a tiny bit of Juvederm for the "11s" between my brows.Also fillers at the corners of my mouth, chin fold and a touch in my lower lip to lift some moderate lines and sinking with a touch of Botox at the corners of my mouth. I bruised heavily! Bruising cleared in 2 weeks.Now I am left with the whole treated areas being slightly darker & a bit red compared to the rest of my face and complexion. Is this normal&how long til it goes away?Safe to do again?

I always apply a topical anesthetic cream (which includes a medication that causes blood vessels to constrict) before injecting "fillers" such as Juvederm and Restylane). The skin is numbed for the injection and is also much less likely to bruise. Bruising is usually minimal to nonexistent.

I usually do not use anesthetic cream prior to Botox injections; the key to preventing bruising is for the physician to immediately apply pressure to the injection site if any bleeding is noted. Again, bruising is usually minimal to nonexistent.

It is also a good idea for patients who are scheduled for injections to avoid any elective "blood thinning" medications such as aspirin for two weeks prior to the procedure.

Robert C. Langdon, MD

Guilford Dermatologic Surgeon

Which Type of Liposuction is the Least Painful?

I'm considering having smart lipo or vaser lipo on my inner knees, stomach and back areas. The only final thing putting me off right now is the fear of the pain. From what I've read, it is a really painful experience. I was just wondering if all Liposuction is the same in this respect or is one slightly less painful than others? Also, are patients allowed to take painkillers beforehand. Thanks :)

Tumescent liposuction, skillfully performed, can be totally painless during the actual liposuction procedure. A painless procedure is possible if the tumescent local anesthetic solution is distributed throughout 100% of the fat volume that is subjected to liposuction. Administering the local anesthetic can also be virtually painless.

I wrote the article "How to Maximize Patient Comfort During Tumescent Liposuction" (available at the "Web reference" link below) to describe these techniques. Also very important to patient comfort, as described in this article, is keeping the patient warm during the procedure.

After the areas to be treated are properly anesthetized, laser treatment prior to liposuction should also be painless.

In the vast majority of my patients pain medication (usually Tylenol) is not needed until after the procedure, when the local anesthetic effect wears off (up to 12 hours later).

Robert C. Langdon, MD

Guilford Dermatologic Surgeon

Will Zerona Affect Breast Implants?

Zerona laser treatments will not affect breast implants. This laser produces low energy visible light that has a specific biological effect on fat cells, but no known effect on other cell types or on any synthetic materials such as those used in breast implants. The low energy "cold laser" output of the Zerona does not even cause detectable heating of the body areas where it is used.

Robert C. Langdon, MD

Guilford Dermatologic Surgeon