Tom at RealSelf

@MOx12 - would love to see the results. I was speaking to Dr. Jeffrey Dover about the Pico technology that his clinic is also trialing. Sounds very promising for tattoo ink colors that current technology can't adequately address. Thank you.

a dermsurgeon friend asked her colleagues, and one suggested checking with Dr. Sheldon (http://www.derma-surgery.ca/meetdr.asp). She also forwarded me an article called "Soft-Tissue Filler Complications: The Important Role of Biofilms" that is worth looking up.

The authors provide this information:

Biofilms and Their
Relationship to Soft-Tissue Fillers:
The cause of foreign-body granuloma after
soft-tissue filler injection has been hypothesized to
be attributable to implantation in one session of
volumes that are too large, impurities in the agent,
or irregularities of the filler surface, but the impact
of biofilms has yet to be established. Reports of
delayed complications temporally related to systemic infections support the infectious cause.

All fillers, especially longer lasting products, have
the potential for biofilm complications....

Complications should be approached in an
algorithmic manner with early recognition (Fig.
2). If possible, one should make every attempt to
determine what was injected into the site. If the
wound is fluctuant, it should be needle-drained
and cultured. Cultures should be sent to the laboratory immediately for appropriate handling.

They also should be monitored for up to 21 days
for routine culture and atypical infections. The
initial antibiotic regimen should consist of at least
two-drug therapy, such as a quinolone and a third generation macrolide, to prevent further biofilm deposition. Macrolides have been shown to be
uniquely effective, which appears to be related to
improved accumulation in the subcutaneous fat
(where the filler material typically resides) and
may also block quorum sensing.

After a trial of antibiotics, intralesional highdose steroids should be considered. If hyaluronic acid was used, hyaluronidase should also be
considered.

Excision should be the last step. This
algorithm is exemplified in Figure 3. This patient
presented with nonfluctuant inflammation following hyaluronic acid to the lips. She was successfully treated sequentially with an antibiotic regimen,
hyaluronidase, intralesional steroids, and eventual
transoral excision.

Hi NewDo. Thank you for sharing such great detail. Wondering if you can provide the name of the person you're warning others to be wary of, so we can investigate.

I also hope you're ok with modifying your posting title ("Don't trust this guy.") At first glance it appears to be warning about Dr. Epstein, whom you rate 5 stars, and you're in fact referring to a different doctor. Your post shows up under Dr. Epstein's RealSelf profile and other places.

Are you ok with "African American female hairline implant surgery and eye brow implantation"?

Thanks much

-Tom (founder of RealSelf)

can you point us toward a website that explains these treatments?

Tiffany_Iowa - you may want to post here about your experience with photos of the eyes in the ActiveFX community. That way community members and doctors can offer more specific opinions.