There are enough features in the photos provided that warrant an evaluation by a dermatologist. Once evaluated, your provider can recommend the course of management, which may include a shave skin biopsy. This is a straight forward procedure that can leave a cosmetically elegant result, while also ensuring the specimen can be sent to a lab for evaluation.
Nodule formation is common after Sculpsure and is a sign that the fat was adequately damaged to produce a result. That is is the good news! Typically these are mildly tender and can be massaged several times a day to soften over time. Remember to stay hydrated, drinking water throughout the day as this will assist in mobilizing your immune system response to clear the damaged fat cells. Occasionally a brisk inflammatory response can occur, with moderate tenderness. However if there is pain that is limiting your physical activity, your provider would want to know about it. Please contact your provider for other comfort care measures and evaluation.
Neuromodulators, or wrinkle-relaxing injections - such as Botox, Xeomin, and Dysport, work by gradually relaxing the muscles of facial expression. As they diffuse and attach to their binding sites, they cause the muscle to relax, allowing the overlying skin to smooth out, lessening the appearance of wrinkles. While it does take some time for this result to be observed, I typically tell my patients the onset of action occurs in 2-4 days, with maximal results seen by about 10 days. Results generally last for about 3 months - often noted as a gradual increase in muscle activity. In general, there is no "limit" to how long one can receive neuromodulators, though one's treatment plan may gradually evolve over time. Infrequently, some patients develop a "tolerance" to certain products, fortunately there are several versions of botulinum toxin available for an easy transition in treatment. In fact, some evidence suggests that continuing treatment at regular 3-4 month intervals may help to maintain a natural, youthful appearance.
