Sam Hanna, MD

Hi,

Sorry that happened to you!  Every once in a while, even with great technique and respect for anatomy, this can happen.  While it generally just needs to run its course (thankfully side effects generally last less long than the beneficial effects of botulinum toxin) you may get some benefit from Iopidine eye drops.  Your doctor can prescribe them.  They can be a bit irritating but they may help.

Hi MaxieLucy,




Sorry this is happening. From your photos it looks like some of the darkness is bruising that is still resolving. That can take a couple of weeks so that part should start to fade. The Tyndall effect creates a bluish Color which I don’t see in your photos. 

Sometimes with tear trough injections, the product can attract water and make the area look overfilled and swollen. That may explain the fullness you have closer to your nose on the right and under your left eye. The other explanation is that a bit too much product was placed there. At this point nearly 2 weeks out, I’d get in touch with the person who injected you so they can have a look. There are ways that they can help this calm down sooner. 

While your 2 courses would have been expected to be very helpful in controlling your acne, they unfortunately weren't in your case.  You and your dermatologist might consider low dose, longer term Accutane maintenance.  The low dose limits side effects like dryness (and more serious side effect risk) and may be enough to finally keep your oiliness/acne at bay.

While your doctor may be able to achieve better results using more aggressive settings, scar/injury risk also increases.

Many sessions may be necessary to effect the best possible outcome (even more than you've already had)

Sometimes, PWS or a component of it does not respond further to treatment.

While newer technologies may be in development to "reach" these stubborn PWS, PDL is still the best current option for treatment.

As with any medical procedure (from taking an aspirin to brain surgery), risk is unavoidable.  Any medical procedure's risks and benefits must be weighed by doctors and patients alike before consenting to proceed.  Lasers have been a boon to many areas of medicine, but none more than aesthetic medicine.  The vast majority of patients who undergo these procedures (literally millions of procedures annually in the US and Canada alone) have favourable outcomes. 

Unfortunately, there are a small percentage of patients who might have an unwanted complication such as scarring, pigmentary change or failure to respond.  Complications can be limited but, unfortunately, not eliminated by observing a few rules

1) Know your doctor:  Who's doing the procedure?  How long have they been doing it and how many have they done?

2)  Know the patient (that's you!):  Are you planning on going tanning or on vacation after laser?  Do you use any medicines or skin creams that your doctor is unaware of?  Do you have any diseases that might make you more susceptible to burning?

3) Know your laser:  What laser is being used?  Is it being used for it's intended purpose or "off-label"?  What are the expected outcomes and possible complications (and how can they be reduced)?

 

As to your question about "approval" ratings and Fraxel/CO2 lasers:  Fraxel was developed as an alternative to ablative lasers like CO2 which, while very effective for the treatment of significant facial wrinkles, has significant post procedure healing time.  Fraxel treatment generally need to be repeated to achieve the desired results but after each treatment patients are better able to get back to their lives/work/activities faster.  It is not a matter of safety but of understanding the tool that is being used.