Jordana S. Gilman, MD

The Tyndall effect is a bluish discoloration that appears if hyaluronic acid fillers are injected too superficially into the skin. The filler is a clear gel so when light reflects through it through the skin it appears bluish.

It is possible that what you are seeing is the Tyndall effect. You mention that you had your nasolabial lines injected and has heavy bruising, and then noticed the discoloration on your upper lip. When you bruised some of the blood may have spread downward into the lip area. Sometimes when a bruise fades there is a discoloration that remains due to the iron pigment in blood. This can look brown-gray-blue depending on your skin type.

I recommend that you return to the doctor who injected you. Certainly consult with a dermatologist who can see and evaluate the area and recommend a treatment plan.

Regular use of Retin A (or similar creams) improves the skin's condition by stimulating collagen production and exfoliating the older, surface layers of skin. However, it can make you more sensitive to the effects of chemical peels or other peeling or laser treatments. In general I advise patients to stop their Retin A one to two weeks before having a peel. Depending on several factors such as how sensitive your skin is, how long you have been using Retin A, if you have had chemical peels before, and what you're environment is like (is it winter in Wisconsin or winter in Miami?) you may need to stop for longer or you may be able to keep using it up to a few days before your treatment. Always ask your dermatologist if you are concerned, but it's better to stop for longer than to not have enough time and end up getting irritated.

It's not uncommon to start with a lower dose of Accutane then move up to a "full" dose after one or two months. This may be done in cases where the acne is particularly inflammatory in order to decrease the chance of a flare, which can happen upon starting the medication. We would expect to see some improvement after the 2nd month. Some of the spots, usually the deeper white cysts, may take longer to improve, but the red pimples and red cysts should be getting better and there should be few new spots occurring.

I would discuss this with your doctor. While every patient is slightly different, you should understand exactly what to expect and when to expect it.

Botox is injected in very small amounts and there is really very little you need to worry about doing or not doing after your treatment.  People used to be advised to not bend over or lie down for 4 hours after treatment for fear of the liquid moving within the skin, but this is really unfounded. There isn't enough injected for gravity to move it somewhere you don't want it to go. There are some physicians who believe that if you use the muscles after your treatment they will "take up" the Botox more quickly, however not all believe this. If there is any difference it is small.

I advise my patients to resume their normal activities after Botox treatments. However, you should not press on or otherwise manipulate the area where you had treatment until the Botox has taken effect.

 

Collagen in the skin becomes depleted or damaged over time.  The result is visible signs of aging such as thinner or loose skin and wrinkles.  Thermage treatments provides skin tightening without surgery, with no downtime, and with very minimal risk.  Thermage uses radiofrequency energy to heat the skin, tightening the collagen and giving a smoother, lifted look to the skin. The treatments are performed in the doctor's office and no anesthesia is needed. There may be some discomfort during the treatment in certain areas. Some people have redness or swelling after the treatment, which usually disappears within 24 hours. Most people go right back to work or resume their regular social activities after treatment.