How to Approach Doctor About Techniques for Evolence?

How do you question your doctor about possible techniques not used when giving Evolence? I have lumps, doesn't really look like I've had a filler (except for my new marionette lines due to lumps). I didn't have any kind of massage with injection, told not to touch my face for 6 hours. There was actually substance left in the syringe (that I paid for) that my lines could have definitely used. How do I approach this topic?

Doctor Answers 4

Talk to your doctor about your concerns

You should see your doctor and while looking in a mirror point out to him or her what bothers you. There are things that possibly can be done to make you more happy. There are some people whose lines are so anchored down that the filler may spread to the sidelines making the skin more full next to the line and even making it appear more deep by raising the surrounding skin. If you try to put more filler in the lines, the same process could repeat itself making the appearance worse.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Talking with your doctor about Evolence

First, a concerned approach reflecting your thoughts is more likely to find a sypmpathetic ear than a confrontational approach. Most physicians inherently want to please their patients. Evolence is a collagen, and unlike the hyaluronic acid fillers, may have a bit more firmness and integrate into the surrounding tissue a little more slowly. Although massage is often recommended as part of the injection process, it is not essential in all instances. Usually lumps are more obvious to touch than to see, and will soften and integrate into the tissue over a few days to several weeks.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Evolence, lumpiness, massage and approaching your physician.

Although massage may be recommended it is not necessarily required in all cases.

I have found that some massage may actually cause or worsen bruising and so I use it selectively in patients.

It is also important to realize that massage does not necessarily guaranteee that you will not have bruising.

Discuss with your surgeon, his/her choice to massage.

Evolence is firmer than hyaluronic products and while it has benefits of minimal bruising and comparable longevity, some physicians prefer not to use it due to paitent reports of lumpiness. For this reason, many physicians avoid using it in the superficial layers of the skin where it may have a tendency to be more visible.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Discuss It In A Non-Threatening Way

You should have a good enough relationshipwith your physician so that you can discuss these issues in a frilendly, mutually beneficially way. I would bring them up in a non-threatening way.

The worst cosmetic experience I have ever had as a physician was a woman who was very adjected and began calling me names after we told her there would be a $200 cost for Cosmoderm. I had performed a lip augmentation two weeks and told her that I would charge her at cost for the Cosmoderm when it came in. She misinterpretted this and when we asked for the $200 became verbally abusive.

However, I am assuming you are not like that. As long as you are quiet and reasoable I am sure you can work your complaints out. This would especially be true if you have had a long-term relationship with your physician.

Perhaps, he/she intended to inject the remainder of the filler at another session. It may be good that he has the excess Evolence and can use it to bulk up certain areas. Evolence is relatively new, and your physician may not have releazed the importance of messaging the filler.

I would urge you go back in a friendly manner and discuss your concerns.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.