Atrophic Lesions After Infini Radiofra from Lutronic Company,earliest Fat Transfer? Roacutane Help?

Like any aetshetic device, there are risks to microneedling with radiofrequency. This risk in my experience is very low, but there are certain factors that can help mitigate the risk:1. The safe  suggested guidelines for number of passes, needle depth, energy delivery should be followed for the skin type. 2. In areas of the face prone to volume loss like the temples, extra care should be exercised to not over ablate the tissue. In some areas like the jowls, one has more flexibility in settings.3. Newer devices that use better circuit boards (chevron circuits), micromotor driven needles, gold guarding down to the last 400 microns, and allow for frequency control (1 versus 2 Mhz) will provide larger margins of safety for practitioner doing these procedures. The latest form of this technology is called the Vivace and we like it providing more options on all these fronts.4. Finally, if fat atrophy does occur, fat transfer is a safe and effective correction. In my experience, fat squeezing technologies like the Lipokit work a little better for device complication induced fat loss. 

Would be interesting to have seen you skin in the first week or 2 after the treatment.  Were there any side effects in the first week or 2 in the sense of crusts or small bumps? Did the skin heal uneventfully initially and now he feels like the skin is waxy and yellow? Oftentimes it is best to return to the initial treating physician as was mentioned earlier, particularly to review photographs and determine what the next best course of action is.  Tincture  of time is helpful in many of these cases.

    Fat atrophy can be treated with fat grafting after dermal changes have stabilized, but other modalities can be used on the skin after the fat grafting to help with skin pigmentation changes.  Alot of therapy is dependent upon current skin pigmentation.

It sounds like you are experiencing dermal thinning or fat atrophy following your recent treatment.  I would agree that fat transfer would  likely be the best treatment for your problem.  This is a procedure that has relatively few risks if performed correctly, and the long term effect of fat will  be very beneficial.  Poly Lactic Acid injections may also be of some benefit, as these injections restore collagen which may have been damaged by the procedure as well.  Either way, your physician  should report this to the company so that risks data can be compiled regarding the device. 

I have performed fat transfers on many patients in your situation ranging from a few months to a few years after the procedure but I do not know the optimal time. My inclination is that earlier is better.  I have treated patients with associated scarring using stem cell enhancement with the fat - adipose derived regenerative cells are isolated from extra fat and injected into the scarred areas along with the fat transfer.  There are no studies on this approach and it would be considered experimental work but I have some happy patients. I cannot give you any insight into the pigment changes.  You should make sure that this complication is reported by your doctor to the company.

I'm truly sorry that you have had issues from the Infini.  However, I'd like to address the concern that this is due to the device.  First, let me make a comparison.  Although aspirin is widely used, if taken in doses that are excessive (ie overdosing), severe problems or even death can occur.  When devices are used, there is a range of settings which are deemed appropriate for certain skin types, areas of the face, etc.  When treatment is outside of these parameters, any device can cause unwanted side effects or complications, just as any drug that you might deem as very safe can.  I have over 500 treatments with the Infini and have had no issues as you describe.  You, in essence, were "overdosed" by the Infini.  You were treated at inappropriate depths and energy levels for you skin/areas of face.  The provider was a sales rep, which is also a red flag.  If the needles are placed at the level of fat in the face, I would guess that fat loss is possible.  The provider needs to place the needles within the dermis, so as to avoid complications such as this.  Also, pictures have never been available, so corrective treatment recommendations are more difficult for us physicians.  The Infini is a very safe procedure with thousands of patients treat all over the globe.  Proper settings and training of the provider are keys to great outcomes with this device.

I'm sorry you seem to have had a difficult experience.  Fat grafting, as well as other modalities can help with all of the issues you describe.  Your next move should be to see a board certified plastic surgeon for an evaluation- without a physical exam, you are unlikely to get too much accurate information.  Ask about fat and fillers, skin treatments and ultrasound therapy.  I think you will be happy in the end.