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MixTo Treatment Great, but Unplanned Disaster Happened

I am 54, have taken excellent care of my skin...

I am 54, have taken excellent care of my skin since I was in my mid-20s - but even so, I had developed fine crinkly lines, more noticeable wrinkles, and even puckery skin in the areas around my mouth, under my eyes, the eyelids, and tops of cheeks. My PS had been telling me about MixTo for almost a year, so after doing as much research as I could on this, I got the treatment done on May 14, 2010. From what I'd read, MixTo is excellent on acne scars and age-related skin rejuvenation, and it was the latter that prompted me to have MixTo over Fraxel or even chemical peels.

About an hour before the treatment, my face was slathered in a topical lidocaine gel; that was followed by 3 pills prior to the procedure: one for pain, one for nausea, and a Valium. I also got several nerve block injections around my mouth and eyes to reduce the discomfort further. So I was woodenly numb by the time the procedure began.

My surgeon was awesome at communicating every single step of the way - from the waiting room to the treatment area, throughout the entire treatment and in recovery - what was going to happen and how that would "feel". That really reduced the anxiety and fear factor a HUGE amount.

Overall, on a scale of 1-10, where 10 is unbearable pain, I'd say 80% of this treatment was 1-2; 15% was about a 3-4; the last 5% was definitely HOT, but the sensation lasted 2-3 seconds at most. After the treatment, I was slathered in more topical lidocaine and cool, moist gauzes were placed all over my face and neck to get through about 30-45 min that I was told may be uncomfortably warm - but it was not! I didn't feel a thing at that point. I was driven back to my hotel to begin the recovery, and now I can tell you: THIS is the part where you're going to need to be strong, positive and confident in the results. The swelling doesn't set in till about 24 hours post. Plus, the skin begins to crust over almost immediately - more so in the areas that are treated a bit more aggressively. For me, that's the eyes and mouth. It's tender, but you can actually manage to gently scrape off the Aquaphor and reapply it yourself without a grimace. I have also tried icing the area, but any material will stick like glue on that sensitive face - OUCH when you try to lift it off. Even so, the icing really helped my eyes, and I will continue doing it.

Pain meds? One Extra Strength Tylenol per day (if even) is what I've had. It's not painful, it's MESSY. Aquaphor is on your hands, towels, clothes, hair, anything you get near. If you're a neatnik like me, it'll bug you blind for about a day; then you simply accept it! Since I'm recovering away from home, I packed camisoles to wear under button-up shirts; also a headband to keep the hair off my face; I packed an inflatable, horseshoe-shaped travel pillow that I place under my head at night - with the legs pointing at the headboard, not wrapped around my neck.

Unfortunately, while the MixTo treatment seemed to go well, I had a very severe reaction to the anti-viral drug Valtrex, which is given to prevent an outbreak of Herpes Type I cold sores. After taking the drug for 4 days, I got nauseous, had uncontrollable diarrhea, a rash, hallucinations, and several other side effects. I stopped taking Valtrex, but my immune system was compromised, and I ended up with a staph infection on my treated skin as well as a fever of 103. It was a long and scary week of recovery from that, and the illness derailed my MixTo recovery by at least a week. I am back on track now and making progress to a very fine outcome. I think it's important to evaluate the recovery from these procedures. If there is any unplanned-for occurrence, you need a Plan B to get through it.

Despite my experience with Valtrex, I would not hesitate for a minute to recommend my surgeon who performed the MixTo. I am confident that I'll have an excellent outcome.

41 Comments

smartgirl06 - lotta questions y'got! I'll do my best to answer them all, cuz there are some facts I want to be clear about.

My MixTo treatment was performed by a reconstructive plastic surgeon - a doctor who had done my facial surgery, and to whom I'd gone to for several years for Botox & juvey injections. So I was very familiar with him and confident in his skills.

That said, I think there were a few variables tossed into the mix that resulted in my own horrific outcome: the staph infection. I was not prescribed any antibiotic to take proactively before the procedure was performed. Since I basically got a 2nd degree burn with the MixTo, that seems remiss. In addition, my face was never swabbed down with a sterile solution - I only recall washing it myself in the pre-op room. Strange?

I had to travel to get the procedure done, so I recovered in a hotel room. Is that where I picked up the staph? Or did I get it right at the surgeon's office? Immediately after my procedure, an assistant put cool compresses on my face, Within 24 hours, I had the infection, which began in my left eye. Also, I smelled putrifying skin, but was clueless as to what that was all about. Turns out, it was the staph infection and my infected skin. But staph is a FULL-BODY infection, and it can kill you if not treated pretty quick with antibiotic.

My surgeon continued to treat me during my 10 days of recovery away from home. He never came right out and said, "YOU NEED TO SEE A DOC!" Or, "I suggest you follow up with your GP when you get home." So I felt he didn't know when to hand me off to someone with more expertise in my infection.

When I got home, I took the initiative of seeing both my GP and a dermatologist. Both of them AGREED that I appeared to have had staph infection, should have been hospitalized, but that their diagnosis was made in hindsight after seeing my post-procedure photos and hearing what I went through.

In my post-procedure list of things, I was never told to watch for any sign of fever. So I languished in my hotel room as it climbed from 101 to 103.6 before going back to the surgeon (DUMB! I should've gone to a hospital) for treatment.

His nurse got me started on an antibiotic IV that likely saved my life. No kidding.

Yes, I can now see clearly that my undereye skin is way more tender and delicate than other parts of my face (or neck & chest, which also had the MixTo lasering). I was incredibly lucky to not be left with any disfiguring scars. Now, almost two years post, my skin looks GREAT! Is that because of the MixTo? I simply don't know. I use some excellent skincare products plus strong sunblock daily.

If my current skin is due to MixTo, then it took a good 1.5 years to shine through! That seems too long. I think it's due to healthy diet and good skin care regimen.

Good luck with your procedure! It sounds like both you and your doctor are not only knowledgeable, but also on the same page about results and outcome.

My only advice is: get the Rx for an antibiotic and take it! You may also get an anti-herpes virus med. So be it. But be scrupulous about your sanitation after the burn and MOST important, if you develop a fever in the hours post-procedure, do not walk, RUN to the doctor for a full follow-up.
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Thanks for the positive feedback, Great! I can't believe it's been 1.5 years since my MixTo lasering and staph infection. To my relief and amazement, I can actually go out with no camouflage makeup now. Yes, there is still a permanent, darkened skin color under my right eye, but no one has ever stared at that eye when I'm out with no makeup on.

Whether related to the MixTo or not, I have not needed to get any Botox or Juvey injections since April 2009 either. Botox did not agree with me: it left large, banana-shaped bags under each eye.

I used to have my tear-trough area filled with Juvey - and that is no longer necessary!

But my "marionette" lines on the sides of my mouth are becoming more prominent now, so I am debating finding a doctor to inject Juvey there.

All in all, I am happy, at peace, and MOST of all: back in good health for over a year now.
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Bugjune! Baby! Wow, what a story!!! You know, a few things stand out to me. I have a background in pre-hospital medicine, and I was wondering, if you were instructed to go to your GP for the follow-up with all of the symptoms you experienced vs. going to your dermatologist? Also, I wanted to make sure I understood that you actually got your procedure done by an assistant PA or the actual Surgeon?

Second, just for the record, skin under the eyes is WAY more thin, sensitive, and more easily damages vs. skin around your mouth, i.e., when the discussion was re: the juvaderm injection possibilities with re: to the "melted" look under the eye vs. around the mouth. It makes some sense, BUT was that point ever addressed in particular by your dermatologist as to why this happened?

Did your dermatologist take any responsibility for what happened with you? It sounds like you went to a few doctors, and were told different things, and it sounds at least like your dermatologist should have provided you more answers than you were given, and he should have known right away more than not, as to what was happening with you BECAUSE it was SKIN related! And that is supposed to be their forte`.

You are a very sweet and brave girl to post everything you did. And I am planning to get the mixto on my face, fraxel on my neck and chest in about 14 days! So to read your scenario was disturbing, but I do agree that you have something that should have been brought out in the history and physical, or at least attempted, as with having a problem with staph, although people may not know something like that UNTIL something like this happens because their system isn't put under "just the right set of stressors/circumstances," you know? In any case, do let me know the answers to these as you are able.

My doctor, who I have known for 17 years, and who is an adjunct professor to a local teaching college at UCI, is someone I trust completely. He says he does not want to "over-promise and under-deliver," so he is very realistic about what things feel like and what they will look like. He said he has never had anyone have a bad reaction, and that it "usually feels like a bad sunburn for about 3-5 days, or longer if skin is very sensitive, which mine is, but I have had a chemical peel under my eyes about 10 years ago with him and the worst of it was the "burn!" JESUS!

Then it was gone and the new baby skin was so damn soft! :)

Anyhoo, get back to me when you can and you have my deepest regards and hope you are doing well.
Bay Area Facial Plastic Surgeon

While he is extremely good at communicating the process every step of the way and has a very good aesthetic eye, he does not appear to have a "crisis management" plan in place. Sometimes untoward things DO happen, and a patient may need to be admitted to a hospital OR sent to a GP doc asap. I feel that is essential for any plastic surgeon: know what you'll do in case of a crisis.

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