Try some hyaluronidase (ie. Vitrase) at your derm's office (cheaper than at a PS - unless the office who botched you offers it free).
Also, yes, it does last longer around the eyes. I've been stuck with a combo of very lumpy Restylane and Cosmoderm for over 2 yrs now. I finally got the Restylane portion dissolved last spring, but the Cosmoderm remains as hard lumps that I massage and it seems to be slowly flattening. (Cosmoderm is human collagen and was supposed to last less than 6 mos).
Anyway, I'm currently stuck with lumpy, hard Cosmoderm & it looks like I have malar bags, to boot. (I also had the Tyndall effect when the Restylane was there.)
BTW, I'm not positive on this, but I think if you had a better injector who had injected less and also injected deeply (under the muscle), you might have had a better outcome. However, I'd be very careful injecting deeply around the eyes. Think I'd have a very experienced occulaplastic do it. Nothing is worth risking the eyesight.
Please file a complaint with your state medical board and with the FDA. When they finally get enough complaints, they tend to act on it. Until they get enough complaints, however, not much will be done. Also, if you later pursue legal action, a complaint to the state medical board if ruled against the doctor will work in your favor legally.
Your pores will most likely be tighter only temporarily. See if they're still tighter in a year. I suspect in a couple of months (if even that), the pores will reappear as the swelling subsides. The swelling also serves to mask wrinkles, ceratin acne scares, and other textural abnormalities. Hopefully, you won't notice any long-term dermal thinning or irregularities this time next year. Best wishes.
Cristine, You have my empathy. Glad to see some of the issues have resolved. Unfortunately, however, not all. As you point out, you have hypopigmentation. In addition, you also have scar tissue which has replaced normal tissue (whether visible or not). Certainly, scar tissue is not normal tissue and it has only 89% of the tensiloe strength of normal dermis. Hopefully, this won't present a problem as you age. I understand your hesitance to shield the doctor, but this doctor was, indeed, responsible for your treatment.
He/she had no business treating a patient if unable to adequately do so. We are not guinea pigs for doctors' learning curves. These people buy these lasers ultimately to make money from them. They need to also accept legal and finacial responsibility. I would certainly talk to an attorney about malpractice. It seems this doctor knowingly practiced on you without adequate knowledge; which, I would think would be under the prevailing standard of care. If you talk to an attorney, be sure it's someone who is willing to take the case on a contingency basis (ie. he/she takes a percentage and you pay no fees, other than court costs, if you don't win). I imagine the doctor will claim adequate standard of care based on the settings used; however, he/she may have a hard time wiuth this one.
I also hope you have filed a complaint with your state's medical board against the doctor. (Enough complaints and they may eventually take action. In addition, it bolsters a malpractice complaint if the board finds the doctor was negligent.) I am also dismayed at some of the posters who seem to try to suggest that somehow you did something wrong - ie. implying your skin was too sensitive (shouldn't the treating doctor have known that), you were on Vitamin A, for example (a. you weren't, b. the doctor should have taken an adequate history to find out), and on and on.
It's almost a "blame the victim" mentality. It's very troubling. As one poster mentioned, this is a CO2 laser. It's simply a "fractionated" version. I almost wonder if that might not be riskier than a traditional CO2 laser. Basically, a traditional CO2 laser takes a lot more skill; whereas, the attitude with the fractionated laser seems to be "put it on the right settings and then go to it with no real consideration beyond the settings." It seems far too many non-physicians (nurses, etc) are administering this laser as well as inexperienced physicians. This is a type of procedure only a very skilled (key) plastic surgeon should be doing.
Personally, I had a full-face deep CO2 (traditional) laser performed about 7 yrs ago. I was literally purple for two months, bright red for about 9 months and pink and sensitve up to the 18-month mark. However, the plastic surgeon was very skilled technically. He knew exactly how deep to go in various areas. He pushed it right to the limit (and hence the long recovery which was discussed prior), yet the long-term side effects were none (other than inducing rosacea for a couple of months). I had neither hyper- nor hypopigmentations, no lines of demarcation around my jaw (many aesthetician has been surprised by that, btw), no textural issues, no scarring, etcetera.
The negative was it really didn't do a heck of a lot, even as deep as it was. I'm pretty sure most of the slight improvement I got was due to subdermal swelling for 18 months. Once my skin finally recovered, it looked close to the same as it always had. At least, the physician was meticulous and skilled enough not to leave telltale signs. The slight bit of difference that remained was a slight blunting of the edges of larger pores. Basically, a tradeoff: less deep pores, but slightly wider.
In essence, these technologies (including deep peels & dermabrasions) work by inducing slight amounts of scar tissue - and that's what's responsible for any long-term tightening of the skin (ie. beyond the long-term swelling). These modalities basically also thin the dermis slightly which, in part, accounts for smoothing of minor irregularities. (For those of you who have significant acne scars, the difference will be imperceptible, so save your time and money - you're trying to treat a crater with a pin prick amount of difference). The one concern I do have is: with a slightly thinner dermis and with slight induction of scar tissue to boot, will I now be more susceptible to visibly aging more quickly. In addition, these procedures will never restore the skin to its youthful, unmarred state. Aside from inducing slight scar tissue and slightly thinning the dermis, there is no mention of ELASTIN.
Elastin is responsible for the recoil in the dermis. It also holds the collagen fibers in a specific arrangement. In scar tissue, collagen bundles are arranged in parallel (1-dimensional) fashion (good in tension in one direction only); whereas, in normal dermal tissue, the collagen is arranged in essentially 2 dimensions (fibers criss-crossing at about 90 angles). No one ever seems to mention collagen arrangement or elastin in any of the discussions about dermal remodeling. Next time, ask your physician about this.
Please, do NOT let a nurse, an esthetician, or a non-plastic surgeon work on your face. Possibly a cosmetic dermatologist who has years' worth of experience performing peels (whether laser or otherwise), but the preference is a plastic surgeon, and a very experienced & skilled one, at that. Also, keep in mind, these peels are money makers. Lastly, the laser companies generally send medical device reps to physicians offices to market these devices. The reps generally have some training (by the company only) and they generally have either a bachelor's degree in marketing or a bachelor's degree in one of the science areas (most commonly, biology). Every once in a while, the rep may be a nurse (and it takes only an associate's degree to become an RN).
These are, at best, genrally undergrad degrees only and the reps basically know only what the company has taught them about these devices. The only mission of the reps is to market these devices. In general, the physicians and their staff members acquire the bulk of their knowledge (& often their only training too) about these device directly from the reps. Basically, this is a very profitable business sold on the hopes and dreams of those who are not very well informed.
To those of you who have had "good" resluts, I'd like to see how well you age, how long those results last, and so on. I find it rather uncanny that these physicians tell their patients (sic), "You'll continue to age." That seems to be the catch-all for results from these devices not lasting beyond a year or two. If these devices work so well, one would expect much longer-term results (afterall, we don't visibly age in 1 or 2 years - 4 or 5 yrs would seem more reasonable for real aging). I'm almost sure I'll hear this one: but my results have lasted 10 yrs. If you're young enough, you might might get a permanent obliteration of a very minor wrinkle, for example, but you will not get any significant relief of any kind of significant wrinkling, scarring, etc. for the long-term duration.
The older you get, the less the effects, btw. Quite ironic considering it's generally older folks who most need "corrections." Essentailly, the "long-term" minor improvements some see are mainly due to the thinning of the dermis just enough to level out an imperfection - or due to slight scar tissue induction. As one ages or in persons with otherwise bigger imperfections, you'd have to practically obliterate the dermis to get any permanent change. Maybe a 3rd degree burn would be deep enough, but that would result in extensive scarring (as with a traditional burn victim). The point here is: these treatments are a tradeoff and only so much can be done; in addition, the "good" effects are rarely permanent - whereas, the "bad" effects are generally permanent (in the form of scars, malpigmentation, etc.). For any of this to work, the patient has to be selected very carefully (and the physician has to be very skilled). If the imperfections are slight enough to improve, but not so slight that the treatment tradeoff is for the worst, then slight dermal thinning and/or scarring might work to improve the "appearance" of the skin.
Far too many people with too little wrong with their skin try to perfect the skin not realizing the tradeoff will most likely be worse. Conversely, far too many people with fairly major skin problems are not properly informed as to the very real limitations of these modalities. Meanwhile, the money keeps rolling. Unfortunately, neither the FDA nor state medical boards do much until a sufficient number of complaints have rolled in.
Please do complain - the numbers are needed. Your complaint does count in that sense.
Recent comments
Posted to Horrible Outcome, Worse Than Before! on 28 Jan 2010
Posted to Fraxel Repair Disaster on Face and Neck on 28 Jan 2010
Posted to Fraxel Treatments - Pores Are Tighter - Newburgh, NY on 28 Jan 2010
Posted to Adverse Effects Fraxel Repair on 28 Jan 2010
Cristine, You have my empathy. Glad to see some of the issues have resolved. Unfortunately, however, not all. As you point out, you have hypopigmentation. In addition, you also have scar tissue which has replaced normal tissue (whether visible or not). Certainly, scar tissue is not normal tissue and it has only 89% of the tensiloe strength of normal dermis. Hopefully, this won't present a problem as you age. I understand your hesitance to shield the doctor, but this doctor was, indeed, responsible for your treatment.
He/she had no business treating a patient if unable to adequately do so. We are not guinea pigs for doctors' learning curves. These people buy these lasers ultimately to make money from them. They need to also accept legal and finacial responsibility. I would certainly talk to an attorney about malpractice. It seems this doctor knowingly practiced on you without adequate knowledge; which, I would think would be under the prevailing standard of care. If you talk to an attorney, be sure it's someone who is willing to take the case on a contingency basis (ie. he/she takes a percentage and you pay no fees, other than court costs, if you don't win). I imagine the doctor will claim adequate standard of care based on the settings used; however, he/she may have a hard time wiuth this one.
I also hope you have filed a complaint with your state's medical board against the doctor. (Enough complaints and they may eventually take action. In addition, it bolsters a malpractice complaint if the board finds the doctor was negligent.) I am also dismayed at some of the posters who seem to try to suggest that somehow you did something wrong - ie. implying your skin was too sensitive (shouldn't the treating doctor have known that), you were on Vitamin A, for example (a. you weren't, b. the doctor should have taken an adequate history to find out), and on and on.
It's almost a "blame the victim" mentality. It's very troubling. As one poster mentioned, this is a CO2 laser. It's simply a "fractionated" version. I almost wonder if that might not be riskier than a traditional CO2 laser. Basically, a traditional CO2 laser takes a lot more skill; whereas, the attitude with the fractionated laser seems to be "put it on the right settings and then go to it with no real consideration beyond the settings." It seems far too many non-physicians (nurses, etc) are administering this laser as well as inexperienced physicians. This is a type of procedure only a very skilled (key) plastic surgeon should be doing.
Personally, I had a full-face deep CO2 (traditional) laser performed about 7 yrs ago. I was literally purple for two months, bright red for about 9 months and pink and sensitve up to the 18-month mark. However, the plastic surgeon was very skilled technically. He knew exactly how deep to go in various areas. He pushed it right to the limit (and hence the long recovery which was discussed prior), yet the long-term side effects were none (other than inducing rosacea for a couple of months). I had neither hyper- nor hypopigmentations, no lines of demarcation around my jaw (many aesthetician has been surprised by that, btw), no textural issues, no scarring, etcetera.
The negative was it really didn't do a heck of a lot, even as deep as it was. I'm pretty sure most of the slight improvement I got was due to subdermal swelling for 18 months. Once my skin finally recovered, it looked close to the same as it always had. At least, the physician was meticulous and skilled enough not to leave telltale signs. The slight bit of difference that remained was a slight blunting of the edges of larger pores. Basically, a tradeoff: less deep pores, but slightly wider.
In essence, these technologies (including deep peels & dermabrasions) work by inducing slight amounts of scar tissue - and that's what's responsible for any long-term tightening of the skin (ie. beyond the long-term swelling). These modalities basically also thin the dermis slightly which, in part, accounts for smoothing of minor irregularities. (For those of you who have significant acne scars, the difference will be imperceptible, so save your time and money - you're trying to treat a crater with a pin prick amount of difference). The one concern I do have is: with a slightly thinner dermis and with slight induction of scar tissue to boot, will I now be more susceptible to visibly aging more quickly. In addition, these procedures will never restore the skin to its youthful, unmarred state. Aside from inducing slight scar tissue and slightly thinning the dermis, there is no mention of ELASTIN.
Elastin is responsible for the recoil in the dermis. It also holds the collagen fibers in a specific arrangement. In scar tissue, collagen bundles are arranged in parallel (1-dimensional) fashion (good in tension in one direction only); whereas, in normal dermal tissue, the collagen is arranged in essentially 2 dimensions (fibers criss-crossing at about 90 angles). No one ever seems to mention collagen arrangement or elastin in any of the discussions about dermal remodeling. Next time, ask your physician about this.
Please, do NOT let a nurse, an esthetician, or a non-plastic surgeon work on your face. Possibly a cosmetic dermatologist who has years' worth of experience performing peels (whether laser or otherwise), but the preference is a plastic surgeon, and a very experienced & skilled one, at that. Also, keep in mind, these peels are money makers. Lastly, the laser companies generally send medical device reps to physicians offices to market these devices. The reps generally have some training (by the company only) and they generally have either a bachelor's degree in marketing or a bachelor's degree in one of the science areas (most commonly, biology). Every once in a while, the rep may be a nurse (and it takes only an associate's degree to become an RN).
These are, at best, genrally undergrad degrees only and the reps basically know only what the company has taught them about these devices. The only mission of the reps is to market these devices. In general, the physicians and their staff members acquire the bulk of their knowledge (& often their only training too) about these device directly from the reps. Basically, this is a very profitable business sold on the hopes and dreams of those who are not very well informed.
To those of you who have had "good" resluts, I'd like to see how well you age, how long those results last, and so on. I find it rather uncanny that these physicians tell their patients (sic), "You'll continue to age." That seems to be the catch-all for results from these devices not lasting beyond a year or two. If these devices work so well, one would expect much longer-term results (afterall, we don't visibly age in 1 or 2 years - 4 or 5 yrs would seem more reasonable for real aging). I'm almost sure I'll hear this one: but my results have lasted 10 yrs. If you're young enough, you might might get a permanent obliteration of a very minor wrinkle, for example, but you will not get any significant relief of any kind of significant wrinkling, scarring, etc. for the long-term duration.
The older you get, the less the effects, btw. Quite ironic considering it's generally older folks who most need "corrections." Essentailly, the "long-term" minor improvements some see are mainly due to the thinning of the dermis just enough to level out an imperfection - or due to slight scar tissue induction. As one ages or in persons with otherwise bigger imperfections, you'd have to practically obliterate the dermis to get any permanent change. Maybe a 3rd degree burn would be deep enough, but that would result in extensive scarring (as with a traditional burn victim). The point here is: these treatments are a tradeoff and only so much can be done; in addition, the "good" effects are rarely permanent - whereas, the "bad" effects are generally permanent (in the form of scars, malpigmentation, etc.). For any of this to work, the patient has to be selected very carefully (and the physician has to be very skilled). If the imperfections are slight enough to improve, but not so slight that the treatment tradeoff is for the worst, then slight dermal thinning and/or scarring might work to improve the "appearance" of the skin.
Far too many people with too little wrong with their skin try to perfect the skin not realizing the tradeoff will most likely be worse. Conversely, far too many people with fairly major skin problems are not properly informed as to the very real limitations of these modalities. Meanwhile, the money keeps rolling. Unfortunately, neither the FDA nor state medical boards do much until a sufficient number of complaints have rolled in.
Please do complain - the numbers are needed. Your complaint does count in that sense.
Best to all of you; in particular, to Cristine.