Can Restylane Between Brows Cause Corneal Ulcers?

Question

Had Restylane injections by Aesthetician in AZ. salon. Is that legal? Excruciating injections around mouth, nasal laugh lines, between brows At least 25 shots & used A LOT of Restylane I looked like deformed monster for 2 weeks - eyes black and blue, swollen shut, lips so swollen I couldn’t speak, hard plump size jowls.

	After 2 days developed serious eye infection. The doctor diagnosed 3 corneal ulcers. 2 and a half weeks later, the swelling was down 80%. Each and every fine line with 40 year old beginner 'wrinkle' is still there exactly as before injections. Now, there are hard ball lumps under the skin at all injected areas! Please help. Thanks so much.

Michael A. Persky, MD · Answer

Hi Hindsight,

They say that &ldquo;hindsight is 20-20&rdquo;, but not in your case until your corneal ulcers heal.
Sorry to hear about your very bad experience with your Restylane injections by an aesthetician. State laws vary regarding the legality of who can inject what into where (sounds like freshman journalism).
The injection of fillers and Botox is a medical procedure fraught with complications when performed improperly as you have painfully learned. Experienced cosmetic physicians, board certified and trained in a cosmetically related specialty (plastic surgery, facial plastic surgery, ENT, opthalmo-plastic surgery, or dermatology) are the only injectors that I would recommend. Yes there are wonderful aestheticians who inject, but not in my face.
You are doing the right thing now, stay in close touch with your ophthalmologist, and seek out the best trained and experienced physician in your area for future rejuvenation.
I hope that your eyes are back to normal quickly and that your facial cosmetic goals are achieved in the future.
Be well.
Dr. P

Kenneth D. Steinsapir, MD · Answer

Dear Hingsight
Aestheticians are not licensed to practice medicine.  I am sure you understand that now.  I am not an expert in the Arizona business and professions codes but I see no where to indicate that an aesthetician can inject BOTOX and Fillers.  The Arizona medical board does permit unlicensed medical assistants to do injections and it is possible that some sharp operator may try to justify the illegal, unlicensed practice of medicine using this angle.  However, the law is clear that such individuals need to be under the direct supervision of a licensed physician.  Direct supervision means that the physician examined you and is in the office and immediately available.  However, it is cerainly possible that the Arizona Medical Board may interpret the injection of these agents as outside the scope of what the law authorizes a medical assistant to do even under the direct supervision of a physician.
The Arizona Medical Board (http://www.azmd.gov/) has some very practical documents that can help you evaluate a potential cosmetic surgeon:
http://www.azmd.gov/Cosmetic%20Surgery/How%20to%20Choose%20a%20Physician%20for%20Cosmetic%20Surgery.pdf
http://www.azmd.gov/Cosmetic%20Surgery/Checklist%20For%20Choosing%20A%20Physician%20To%20Perform%20A%20Cosmetic%20Procedure.pdf
Also this site has information on how to file a complaint with the Arizona Medical Board.  I assure you that they will investigate your complaint if your file a report.  Many spas operate because state medical boards lack the resources to find and close down all of the illegal clinic and spa situations out there.  This treatment almost caused you to go blind from corneal ulcers.  Taking action to report this individual may very well save someone else.
Could you develop corneal ulcers after a treatment like you describe, absolutely.  Please do not get treatment in a salon again (I am sure I don't need to tell you that.)  Stick with a core physician: General plastic surgery, dermatology, facial plastic surgery, and oculoplastic surgery.  I recommend you see a good cosmetic dermatologist to see if the lumps you are describing can be dissolved with hyaluronidase.  Don't be surprised if it turns out that you were not treated with Restylane.  Sometimes these dishonest practices use illegal fillers like silicone oil which is much cheaper than a legal filler like Restylane.  There are truly excellent, highly ethical physicians in Arizona who can help you.  I can recommend Miriam Cummings, M.D. in Scottsdale, a well regarded cosmetic dermatologist.

Steven Wallach, MD · Answer

I do not know the exact laws in Arizona, but in NY aestheticians are not allowed to perform injections.

Bryan K. Chen, MD · Answer

I am sorry to hear about your horrific experience.  Individuals such as yourself who have been victimized by this kind of medical and ethical malpractice can take action to help prevent this sort of thing from happening to other people.  I would strongly encourage you to report this incident to the Arizona Medical Board for further investigation into the practices of this salon.  I suggest you consult with any of the specialties already listed by Drs. Steinsapir and Persky. 
Of course, just because a physician in one of the cosmetic-oriented specialties has board certification does not necessarily mean he or she is a good doctor - talk to your friends who have undergone cosmetic procedures with plastic surgeons, oculoplastic surgeons or dermatologists for recommendations.  If you decide to seek the care of a dermatologist, to address the residual nodules in your face, consider Dr. Susan Van Dyke, an experienced cosmetic dermatologist in your area.  You need to have the sense that when you are consulting a physician, he or she regards safety as a top priority and educates you regarding the common and serious risks and complications of any procedure you elect to undertake. 
I wish you a speedy, uneventful recovery.

Can Restylane Between Brows Cause Corneal Ulcers?

Answers (4)