Don't tell your patient you don't know what to do and to find someone else - Beverly Hills, CA

The $2200 reflects one syringe of Voluma $900-950...

The $2200 reflects one syringe of Voluma $900-950 and 2 of Restylane. I went to Dr. Stevens 2/19 of this year for Botox & Restylane injections for my lines & dark circles. I had Restylane once before, about a year ago & it helped. He suggested Voluma for my cheeks since I have a thin face & said I would love it & lasted 2 years. He injected 1 syringe along with1 of Restylane. I had to go back on the 26th because it wasn't even. I should mention he left me waiting in the reception area while talking to someone who had no appointment & had never been a patient. I thought it was very rude when he knew I was sitting there & mentioned it to him. He said he just came in his office and sat down, perhaps you can say you have a patient. I felt rushed & every time I'd point something out he would say, oh, your crazy, not in a mean way but flippant & didn't appreciate it.

My face had a bubble like lump, extreme redness & had never looked like that. I was very upset by the whole incident & emailed him explaining how I felt along with photos. He assured me that there was nothing to worry about. It did finally subside but by the first week of May, I noticed a lot of bruising, redness & the same blister like lump plus the left cheek was very swollen.

JUVÉDERM VOLUMA™ XC is a Hyaluronic FDA approved (10/13) filler for the cheek area to correct volume loss. I would think it's important to know all the possible side effects & how to treat a patient in case of an infection or reaction. He never mentioned anything about a Biofilm infection or that it was harder to dissolve if there was a problem because it is a thicker substance. I left a message that night and went in May 8th. I don't know if he was annoyed by my email but felt he minimized my concerns & said he didn't feel any lump. I actually had to place his hand on the lump and finally said he felt it. There was no way you could miss it. He explained the redness as rosacea which I've never had. I asked specifically if I might have a biofilm infection. He said I didn't but the tone implied I had no idea what I was talking about. I also asked about dissolving it but he said not to do anything at the moment. I left the office feeling very uneasy & asked if I could send him pictures since he brushed it off which bothered me.

I sent more on the 12th since it was mother's day weekend showing how the redness had spread down my cheeks. He called at the end of the day & said he really didn't know what to do & should find a doctor who had experience with adverse reactions. He did confer with a dermatologist who suggested I be put on antibiotics for a possible BIOFILM infection, the same one he so readily dismissed when I asked. I told him I called Allergan, the company & there had been some reports & even found some cases where doctors explained the specific symptoms & treatment. He wasn't aware of anything like that & even asked me to forward the site to him. He prescribed Biaxin for 10 days & gave him my pharmacy to call but they hadn't received it 15 minutes before closing. I was anxious to start & had to email him the name of a 24 hr. pharmacy. Why make a patient wait who is so nervous? He said to follow up next week. I think a doctor should be the one to follow up, not ask your patient to give you a call. I spent the next 48 hours researching every doctor to find the right one. 

I feel it's best to err on the side of caution & make sure the patient is taken care of even if that means bringing in another doctor. It's a very frightening experience, especially anything around the eyes and felt so alone. I've had 3 injections to dissolve this & shouldn't have been sent home with a lump in the first place. I can't fathom why he thought it was fine but doctors need to listen to their patients. I may not be the expert, but I do know when something is wrong. If you don't know how to deal with an adverse reaction, perhaps it's not a good idea to inject these fillers until you do & make sure your patients are aware of all possible risks BEFORE any procedure.

I requested a refund on 5/15 since he told me I should find another doctor that can deal with this but asked me to sign a release which I can't since I haven't finished treatment. He has known me for years & feel a caring physician would have offered not only to reimburse me but also to pay to have this corrected. It wasn't a large amount of money but regardless, it's the right thing to do instead of running to an attorney or malpractice insurance company. 

I've heard NOTHING from him, not a call, an email to see how I'm doing, could he help in anyway or follow up on my progress. IT DOESN'T COST ANYTHING TO CARE BUT IS INVALUABLE IF YOU DO. IF you're inexperienced with reactions to these cosmetic fillers & tell your patient to find someone else, why should they pay the cost? I want people to be aware of what can happen & to be extremely cautious!
After this review, his wife repeatedly berated me on Facebook to the extent I had to block her. It's a very poor reflection on both of them!

UPDATE AFTER 3 INJECTIONS TO DISSOLVE FILLER
After reading everything possible to learn about infections and complications with facial fillers, I've learned some of the causes can be; how the doctor does the injection, the product itself, not cleaning the area properly which can allow bacteria in or how it was stored. Dr. Stevens had to go down the hall for the product since he didn't have it in his office. I'm not saying this caused my reaction but you do have more control if it's in your office at all times. The photos I sent the next day clearly showed a blister like lump and redness which should have triggered enough concern to want to check it out.

This has been a nightmare and having his wife write such slanderous comments on Facebook, such as accusing me of extortion is deplorable. The fact that Dr. Stevens allowed it, speaks volumes. It will be interesting to see how the medical board views this. What happened to patient/doctor confidentiality? I asked for a reimbursement because he said he didn't know what to do and to find someone who was experienced with complications so now I'm paying to have this fixed. I think it's wrong to wash your hands of the situation and keep the money! She accuses me of being litigious yet the only thing I've been involved in, was one of the largest financial elder abuse cases in CA. and fought for legislation to help seniors.This could have easily been avoided by simply making me feel that he would do everything possible to correct it and that we were in this together. That doesn't cost a dime!

Beverly Hills Plastic Surgeon

I have covered it above but the three main points are: Listen to your patient and don't minimize their concerns, Don't have your wife make slanderous comments on Facebook or talk to her about your patient Don't write emails that conflict with what you said. Don't use a product that is not physically in your office Don't leave your patient waiting for 45 minutes to talking to an aging movie star who has no appt. and has never BEEN A PATIENT Don't infer that your patient doesn't know what they are talking about Don't inject these fillers if you don't know what to do when there are infections and adverse reactions Don't let your patient go home with a lump that is red. Another doctor had to puncture it as it was full of fluid Don't tell the patient she doesn't have an infection, then a day later put them on antibiotics because of one

1 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
2 out of 5 stars Payment process
3 out of 5 stars Wait times
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sorry to hear that you have had this issue. i wanted to add that dr. steinsapir in beverly hills is also supposed to be a great revisionist and he is an oculoplastic surgeon, but also an expert with fillers and anything involving the eye area. i went to him for a consult and saw quite a few photos of revisions he has done. may be worth a chat.
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i wanted to add that dr. steinsapir in Beverly Hills is also supposed to be a great revisionist and he is an oculoplastic surgeon, but also an expert with fillers and anything involving the eye area. i went to him for a consult and saw quite a few photos of revisions he has done. may be worth a chat.
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Hi . I hope you feel better soon . I so want to be able to comfort you And tell you that you will be fine but iam sick to my stomach hearing that word And will not say it because i myself DO NOT belive we will be fine . The symptoms speak volume . 4 months later is much worse then the first day so I don't have hope Atleast not for myself . But it seems u had diffrent filler so there may be hope for you . Wish you all the best and may you be able to have your life soon . Dr do take the oath "do no harm" they just forget to practise "do no harm " oath .
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Thank you and know how you feel. I have to have lower eye surgery and still try and get this lump out and then fill them again which of course, is very risky. I can't have a fat graph since I am not a good candidate for it and am out thousands of dollars on top of all the misery. I can't go out anywhere without glasses and am so depressed. This has been the worst summer and it effects my whole family because I they see how upset I am and don't want to do anything. The doctors just go about their merry way and leave the patients crying everyday and make millions doing it.
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Hi guys, read these new posts and wanted to let you know I researched "hippocratic oath" recently and they no longer use it, there is a revised version that is used in some places but for the most part the profession has done away with the "oath." Since I also went through a lengthy bout with lumps after filler I also want to let you know the problem with "correct diagnosis." One surgeon suggested a silicone filler may have been used based on my path lab finding so I had a conversation with the pathologist who did the report (which took a lot of work to get through to because as a rule they do not talk to patients...you must go through your doctor) and he refuted the suggestion of silicone! This is why it's so hard to sue a doctor for just even your costs let alone "pain and suffering"... the experts will all disagree. Seems the medical-legal system is now designed to protect doctors not patients. This frustrates really good physicians who sometimes try to report another physician/surgeon for harming patients "the system" (medical boards, etc.) gives the defendent-physician the benefit of the doubt, until more than one patient dies under his/her knife and then that's where they draw the line. I read a case about a Texas neurosurgeon where that very thing happened and the state board merely suspended his license. Why? Because his lawyers could argued other health issues could have caused his patients' deaths...never mind numerous others reported crippling incisions and botches for years and one had even witnessed him using cocaine during his residency...sheesh! I went through a very long journey of enduring a humiliating botch on my lower face and it took one small improvement after the next with more botches in between to finally get healed have my skin restored to normalcy again, but that's mainly because I didn't know how to pick the right surgeon. While reading about silicone on RealSelf, I found this surgeon who specializes in difficult filler removals you might want to look into...first name "Raffy" but let me get back to you with a link.
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Hi guys, read these new posts and decided to share something I learned. The "hippocratic oath" is no longer in use in most places and if an oath is used it's a new version. I also just finished a conversation with a pathologist about his report for my filler related lump excision and he could only supply an opinion which was contrary to another expert so it seems the medical-legal system is now designed to protect doctors not patients. This frustrates really good physicians who even when they do the right thing and report another physician/surgeon for harming patients the system gives the defendent-physician the benefit of the doubt, until more than one patient dies under their knife. I read about a neurosurgeon in Texas who was reported by hospital staff repeatedly for botched incisions that left some patients crippled and it wasn't until two patients died after his surgeries that the state decided to suspend his license...not revoke! Why? Because lawyers argued other health issues could have caused the deaths. Bottom line, work past the sadness and anger and keep looking for the right help. I read about a surgeon in California who has helped lots of silicone injection victims. His first name is "Raffy" and I'll get back to you with a link to his website.
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Have you seen Raffy Karamanoukian? http://www.surgery90210.com/face/62/silicone-lip-removal.aspx
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ooops. my unedited version got posted...okay so you get to read more juicy details.
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I am glad to see you have finally gotten back to normal and you are so right when you say the system no longer protects the patients unless you have a firm for a class action lawsuit but no doctor will go against another. They will always find an expert medical witness to agree with them which leaves the onus up to the patient. The only thing patients do have is the social media as far as reviews and sites such as vitals and healthgrades. I did a review on yelp and his wife posted slanderous comments on facebook that I was trying to ruin his career. Allergan should take responsibility for reimbursing patients when there is evidence of a so called bad batch. It is bad enough to have deal with the medical side but the emotional toll it takes is 100 times worse.
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"Wow" is about all I can say that isn't profane about a doctor who would talk you out of doing something to help the situation HE CREATED. I feel so bad for you, I hope you found help. Any doctor who simply walks away from a situation he/she created shouldn't be in business, I don't care how many successful results you've had. That is despicable. Don't they take some oath about "do no harm"???? Hope you are getting help.
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I had a nightmare once with a filler injected in my checks by a RN (who I later found out had only been injecting a year) the filler went up into my left eye to my eyebrow. I found an incredible doctor at a Duke Aestetic Center ...Dr Charles Woodard and he injected the reversal agent (only needed a very little) and I was back to normal w/in days. He is a PS specializing in the face and neck !!
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I wish it was that easy but I have had 6 injections to dissolve it and once a granuloma forms it can't be dissolved unless you want to try steroids which causes a host of other problems. If this ever goes away, I will need an eye lift to remove all the stretched skin and probably a fat graph so I can't reject it. It is a mess and so depressing. I am glad everything worked out for you!
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I am so sorry and I know just how you feel. I wish you lived on the east coast as all the doctors at Duke are incredible. I really feel Dr Woodard could really help you out, I will only see him regarding my face from now on. He does eyelid surgeries and all things pertaining to the face and neck. There are two other great doctors there as well, dr Julie Woodward and Dr Michael Richard. The last two doctors specialize only with the face. You are in my prayers and sending you a hug.
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More people need to know about this. these Doctors need to be responsible to their patients. All he cared about was the MONEY. I'm looking to have something done for my face. Glad to know not to see this so called Doctor.
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Don't waste your time in court. It's elective and the judge's have no sympathy. Ask for your money back. I spoke to a mal practice attorney after multiple issues with PS and fat injections. He said its super difficult to prove malpractice in this arena as you have show their was intent to do wrong. These doctors over state their capabilities and we, like little lambs, believe them when they say they can "fix us" Here's what I've learned NEVER DO FAT, HYURLONDAISE OR KENALOG. The enzyme and the steroids wreak havoc on your natural fat and tissue. Voluma, resty, all of those fillers are like rolling the dice. Whether you go to great docs, so so docs, it doesn't matter. I've had great filler and then not so great filler. It's always a crap shoot. If you're having problems in the LA/OC area-go see Val Lambros in Newport Beach-he's super conservative and will tell you what can and can't be done. I went to him after a TOP surgeon screwed up my face. He was honest. He also knows a lot about filler. Hoenig in BH is also pretty honest. My best recommendation-time. DO NOT LET ANYONE INJECT STEROIDS!!!! I let some moron do that to me and it made a mess. Sorry you're going through this. You won't get sympathy in the courts though. It will just upset you more. My doctor had comments removed from Yelp and other sites. THEY PAY BIG MONEY. It's such a joke. Good luck-hope you find a solution
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4halex, I was going to say the same thing as RedRoxie about judges and courts. If your P.S. who injected the Resty/Voluma will refund your money with an agreement that's a good offer. I signed an agreement and it helped pay for the next repair. The problem was I wasn't smart about who I picked for the next one, and the one after that, etc. etc. It wasn't until last year I learned about RealSelf and decided to up my number of consultations and then select based on my own common red flags list I developoed, and I encountered plenty of red flags in several consultations. A small percentage of these surgeons are true artists, look for them if you want a good cosmetic result. My final two turned me into a hollywood version of myself...no lie! Also, when it comes to injectibles don't let anyone offer too much too soon which is what I felt your surgeon did wrong that my injector did not, and he went to great lengths to explain his conservative approach. Also, your surgeon really has to show he loves injectibles because some only do it for some quick income while others do it because they love what they can get it to do. Make sure your next surgeon's "pet procedure" is periorbitals. Like RedRoxie said, the industry is a crapshoot and it's up to you to do the careful choosing because no one cares about your poor cosmetic result and will blame it on roseacea (sp?) your immune sytem and eventually if they think it's "biofilm," they'll refer you to a different specialist; bottom line, cosmetic surgeons are not obligated to treat medical conditions and more often than not patients are getting treated elsewhere after things go wrong. That's why I said try a double boarded ENT Facial Plastics, Cosmetic and Reconstruction surgeon next because they're trained to treat illness and infection of the head and neck but then they are not all created equal when it comes to cosmetic results so be sure to interview a few of them before choosing a surgical procedure!
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Robert Goldberg at UCLA is top notch in fillers and eye area. Groth is really good, too. Not sure who's doing repair work these days. Call them both They're at Jules Stein eye institute
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I did call Jonathan Hoenig but he will not take on any revisions. I think I did email Dr. Goldberg and will follow up with your suggestions. Thanks so much for your help!
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Have you found an ENT willing to help? I will travel anywhere to get fixed.
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I actually went to see Dr. Hoenig's associate and she said not to operate because it could make things worse. I am going back on Tuesday and most likely will see an infectious disease doctor. I just want to make sure the infection is gone so I can do a fat graft or figure out a way to fill them up. I will have to get a lower eye lift and then go from there. I am so sunken and hollow with the lump so depressed is an understatement. Hope everything for you is going better!
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I went to see Dr. Wang who is in the same office as Dr. Hoenig and with Jules Stein but she said it would make things worse to try and get this out. They all say the same thing, it is really a difficult problem and it could last for 3-5 years. The lump is better but I need to have an eye lift and to put some kind of filler in so I don't look like a Basset Hound. These doctors don't spend a minute thinking about what they have done but there isn't a minute that goes by when I don't think about it.
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4halex, so sorry for your experience which seems especially excrutiating because the area of your face involved is the eyes, the first place everyone looks at on a person. If the doctor's wife mentioned you by your REAL name on FB that's a huge no-no and hopefully you documented the evidence otherwise I can tell you first hand medical boards don't have sympathy for "botched" cosmetic procedures or calloused behavior in surgeons and yours was incompassionate to say the least. A surgeon gave me a disastrous Kenalog injection in 2005 under my chin which when I returned to discuss the damage and how much my repair cost he agreed to refund cost of the Kenalog injection ($250) and the cost of the proposed repair another surgeon offered, since he also appeared to not know how to repair the damage. He also kept scheduling me for follow ups for as long as I wanted to discuss the poor result under my chin, including from the repair surgery which he had to agree looked terrible and he didn't try to make me sound "crazy." However, surgeons are not obligated to be sympathetic and they'll say whatever they want in the chart about dismissing you. By the way, Kenalog has done untold but no one has ever been successful with a class action suit because the damage is due to the usual suspects...improper dilution, poor injection technique, wrong treatment choice for the best cosmetic result, etc. When it's cosmetic it's all subjective and the consent form cover's the practioner when things go wrong with the product. But you definitely have a good cause for complaint for the FB posts under privacy law and medical practice acts standards. So how are things looking now? Has it been getting better and have you found anyone who has been able to provide you with some relief?
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I never signed any consent form before this procedure, I may have several years ago for Juvederm or botox but not this year. Voluma is a new product and was not told anything about the risks and still don't know if it was the Restylane or Voluma or combination. This was not a class action suit against Kenalog, it would be for Voluma and or Restylane. The doctor ignored everything I said and have emails and photos that were sent to him plus emails that contradict what he said. As for the wife, it was posted to my Facebook page and used my first name. There is no mistaking with the things she said, that it wasn't intended for me and have saved everything. When speaking to this large firm who has done some of the biggest cases in the country he was mostly interested in any other stories which is why I told him to look at this site. The steroid injection has just made my eye very red and the granuloma is still there which was diagnosed by a doctor. I am seriously thinking of having it taken out, I don't want to have 3 or 4 more injections over the next 4 months. I will take this doctor to small claims since it goes up to $10,000 and feel I have a solid case. He admitted he didn't know what to do, would only consider reimbursing me if I signed a release which would be impossible since I have further complications and his wife accusing me of extorting money and ruining his career over one review. I am devastated about this and cry everyday because I don't know if this will ever go away. These doctors should not inject these fillers into the tear trough area if they have no experience with adverse reactions and complications.
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Not signing a consent form does make your situation a lot different! My mention of Kenalog was an example of a product that gets lots of complaints but I realize now it is not quite the same as what's going on with Voluma used in the tear troughs. I checked RealSelf Q&A's and a couple of "experts answers" agreed Voluma is for mid-face and hasn't been used in enough trials for tear troughs...you've probably already seen those posts. In Texas I was told you need an "expert report" to sue a doctor in small claims, due to something called the Texas Tort Reform. California is much more plaintiff-friendly so sounds worth your while. As for the wife, sheesh!!! Highly unlikely your review is "ruining his career"... they'd have to come up with some pretty compelling evidence to prove that. If he were even slightly concerned about it ruining his career he would have resolved it already so best you file your complaints and try to resolve it that way. Truly sorry about all your trauma and hopefully others will read and turn down Voluma in tear troughs if they are offered it. Hope all goes well finding a surgeon to remove the stuff and leave you in good conditions. I'm pretty sure there is someone out there who can give you a good result and put an end to your nightmare. Don't give up! Good luck and keep us posted.
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Wait...did you say you had a steroid injection and might have more? If that steroid is Kenalog my advice is don't. It made my granulomatous lumps much worse when they could have and should have been removed. Last summer my internist felt the lump and advised removal from an "err on the side of caution" standpoint but little did he know how tough it would be to find a plastic surgeon willing to remove it, since they don't like following another plastic surgeon's botch, understandably. If I were you, I'd go to a very experienced ENT Facial Plastics and Recontruction Surgeon with lots of interest in periorbital repairs, or an Occuloplasty Surgeon. But definitely not another Plastic Surgeon and probably not a Dermatologist. Once again, good luck!
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