Infini RF gave me under-eye hollows! San Jose, CA

My acne scars were minor - I'm perfecting past work given this new treatment.

I have these areas that fractional CO2 laser didn't help:
- 2 small icepick scars
- a 1 sq inch area of rolling scars.
- a 1/2 inch linear scar

Some remaining areas where CO2 laser DID help a lot, just looking for more
- some stitches
- scarred pores

My other acne scars (never very deep, but noticeable) were removed with ablative and fractional CO2 laser - specifically 'coolaser'. I never noticed tightening with it - but was extremely happy with the scar improvement. I also use RetinA and copper peptides.

Oh, and by the way, when I say "they" called me back in to the office it was the practice manager (the money boss) that did so. I got Botox for forehead and Voluma for cheeks first, about a month before my Infini. My main concern then was loss of mid-face volume and a flatter right cheek due to a bout of Bell's palsy 10 yrs ago. I wrote about this in the "concerns" section of paperwork, also told the doctor in our first consult. But when I sat down for my treatment and mentioned right side AGAIN, this woman (a nurse!) said I was wrong. We went back and forth 3 times and by then I just held my breath and prayed. When she went round to the right side she admitted -surprised- that indeed it was flatter. Naturally I complained and was asked to come in. I was given an IPL for right side bruising. I think it helped. What is is scary to me about this office is that I've had legitimate problems and this money manager just gave me bull about the "above and beyond" care I've received there. Any truly responsible clinic would have done so without blinking. The extra treatments I've gotten are corrections/support to procedures I've already paid for, not "gimmes". My bad, I should never have gone back there but only affordable Infini is 40 minutes from where I live.

smacpt53 - I had read/heard multiple places not to do RF following any injections due to volume loss of the filler. It can be replaced, it's just a waste of $$ and downtime for the filler. My recommendation is to space your 2nd Infini treatment until a few weeks after the redness is fully gone (plus hold off on fillers until done with Infini). I've read that if the skin isn't fully healed between needling in general, you can create a more chronic state of hyperpigmentation. Hard to be patient, I know.

As for redness/swelling, I'm not big on steroids, but actually did take 2 doses of prednisone. My face still looked like those after pictures of 'cat lady' (Jocelyn Wildenstein), except redder and not lumpy - just misshapen. Knew that was temporary since I got it with CO2 laser in the old days also - before they improved them.
smacpt53 - I had read/heard multiple places not to do RF following any injections due to volume loss of the filler. It can be replaced, it's just a waste of $$ and downtime for the filler. My recommendation is to space your 2nd treatment until a few weeks after the redness is fully gone. I've read that if the skin isn't fully healed between needling in general, you can create a more chronic state of hyperpigmentation. Hard to be patient, I know.

As for redness/swelling, I'm not big on steroids, but actually did take 2 doses of prednisone. My face still looked like those after pictures of 'cat lady' (Jocelyn Wildenstein), except redder and not lumpy - just misshapen. Knew that was temporary since I got it with CO2 laser in the old days also - before they improved them.

I agree with you 100% that it's unprofessional and hurts the credibility of an office when they deny any obvious negatives - I've been there multiple time. I know it's lawsuit fears - which is unfortunately because my goal is always to just address the drawback.

Before/after pictures help with the right lighting; we really know our faces, don't we?

Good luck to you - keep us posted.

Hi Smacpt53,

Really I think you will be ok. I've found from laser treatments that redness DOES subside over time. It took me up to 8 weeks once. I will qualify that with: It's important to stay away from the sun, no other treatments or exfoliation, and truly let your skin heal to avoid a perpetual state of hyperpigmentation. I even avoid most products unless they are truly soothing.

I know folks like the cortisones, both my laser doctor and my Infini-RF doctor wanted me to use them. But I wouldn’t do it for too long or the cortisones can thin the skin - especially on the face. (you can go ahead and research that re cortisones).

When my hands got crazy red from laser and wouldn’t heal quickly, My laser doctor also suggested zinc oxide (yes like for diaper rash!) and it was a huge help. I admit I think that was for my hands, but you can try a small patch on your face to see.

The other thing that helped my redness was dunking my face in a bowl of cool water (just cool enough to feel good on your face) for 20 seconds at a shot.

I will post an update soon (it’s mixed and my hands are still really red and irritated) but it’s late – I just wanted to give you some encouragement. Now I can’t say every treatment resulted in an improvement, but I can say that the redness should go away.

Good luck, talk soon.

Please don't take my one post (out of dozens on Infini) out of context. I'm the most experienced user of Infini in the country. The marks that were present in the one post that is referred to is not possible with Infini. The device uses needles and can't leave linear marks. It can leave temporary stamps of dots which last for a up to 3 weeks. I don't know if treating hands is useful. Most of the aging related to hands is pigmentation and volume loss, not laxity. I treat hands with lasers and filler.

Dr. Wiener,

My post on your comment was absolutely in context and accurate. I've already read *3* posts on the Q&A about Infini-RF leaving them with track marks. (BTW, I make #4 - so it is not even 'rare'. Though mine healed quickly )

Your reply to three of them, including me on this thread, is that it wasn't possible. Yet I just found a one post where you did acknowledge the possibility for 'pilot error'.

"The tip overlap should be about 10% max and passes should be done in different directions in order to create an even response. I am wondering if there is a possibility that there was no overlap and all passes were done in the same direction resulting in track marks of treated skin along side areas on nontreated skin. "

Further, there is a online debate whether the needling stamping or rollers are more likely to cause microtearing/scratches, but we all know that the system operator has an impact, in spite of safety me

I know you have been a Lutronic Infini lecturer and physician preceptor, so you effectively feel you take on a role as a spokesperson for the product. My suggestion to you is show respect for the concerned patients as you did above, not to say to each of them that ‘it’s not possible’ or that they ‘really didn't get Infini RF’. The treatment is so new and multiple doctors would have to get a big machine and attached a dermapen to it. My own dermatologist is legit for sure - I respect him highly.

TO REALSELF STAFF: I hope that you leave in my comment here even though I disagree with a doctor. The whole point of your forum is to give honest feedback. I understand that you don't let us comment on your Doctor Q&A, but this is my own thread that I created where Dr. Weiner is joining in. It's only fair that I can reply. 4 of us saying we got lines/ tracks is real. (again mine were temporary)

BTW, my intent is to post along the way - that's the only way for folks to know that I didn't screen for a positive result first.

And I saw 2 patients at this dermatologists that were extremely happy with Infini-RF and read the positive clinical study. But we have yet to see any product on RealSelf that is 100% effective or where someone didn’t get a negative result, even if it was pilot error.

I'm still waiting to decide on its effectiveness for my face. I'm not like the clinical trial patients in the study on pubmed as they had never had any scar treatments done and I'd already seen major improvement with CoolFrax (CO2) by a doctor in Beverly Hills.

HANDS

- Fortunately I haven't had issues with hyper-pigmentation on my hands (always avoided the sun).

-I absolutely have laxity – I can grab the skin a the knuckles, like elbow skin.

-Multiple laser treatments did not help at all unfortunately (in contrast to being a miracle for my scarring).

-Every doctor wants to do expensive filler for hands, but I've avoided that for multiple reasons that are off topic here.

The good news: Even though multiple laser treatments didn't help me, I saw amazing results in my hands - both tightening and texture - with a combination of 1) BBL, 2) normal micro needling and 3) PRP in one session at my dermatologist about 3 months ago.

I know that Lutronic is not pushing for Infini-RF for hands right now - this is a test on my end. The jury is out i.e. right now they still look worse on day 18. But it’s still early. I had before pics taken, so I will have a fair contrast when done.

Respectfully Dr. Weiner, perhaps my description wasn't clear. Of course visible grid marks from the treatment can occur. The "streaks" I talked about run diagonally and are about 1/3 inch wide; they are smooth and alike in appearance. They look nothing like Infini marks. I wonder if they are almost like a stretch mark one can get from excess stretching of the skin (my full facial swelling was tremendous, eyes were slits). Also in one talk you gave you said fullers should only be combined safely with Infini if it is injected BELOW the dermis. Could you describe the possible side effects of injecting mid-dermis? Many thanks.

There is no harm in fillers placed in dermis just that they might not last as long. I can't advise on what you describe. I've never seen it. Everything I've seen has improved and/or resolved.

Thanks for reply. Will continue to work with my doc on this side effect.

Smacpt53,

Based on what you have described, I have an idea of what it might be. The energy was too high (for whatever reason, wrong setting, machine glitch, over-repeated strokes to the same area) and that area got 'burned' a bit.

I had this happen to me during an Exilis RF treatment ~ 2.5 years ago. Even though it was skin level only and the aesthetician closely watched the temperature to keep it in the target range, I had about 12 red crescent shaped 'burn' marks all over my thighs. I never went back to Exilis after that (or RF at all until Infini).

I showed that dermatologist at the clinic at the time, the best guess was that the Exilis head was faulty - in this case, given the shape, the edge the head was giving off too much energy and overheating/burning the skin.

The reassuring news for you is that this was also RF and the red resolve totally in 3 months. :) I will say that the skin texture there was different - dryer/more damaged. Recently I did BBL and my skin texture there is much smoother again.

Also, I had the same super-swelling - my doctor said that some patients absolutely get this. I've had that same super-swelling with CO2 laser - to the point of eye slits also, and never got stretchmarks from it. That doesn't mean that yours aren't stretchmarks. I'm just trying to give you hope. Especially since I have not once read about stretch marks from swelling from a skin treatment. Fingers crossed for you!

You're very lucky to have little swelling and brief redness. It's an aggressive treatment by nature in that it is 2-fold, puncture plus high heat. Though come to think of it my neck and jawline were NOT problematic just as you say yours were. Maybe cheek area being softer maintains redness longer. I hope this is the case, my cheek redness continues at the "apple" portion.

Thanks so much Smacpt53. I really count on these reviews myself - they stopped me from doing Cellulaze when I read that so many got the hyper-pigmentation from excess iron deposits.

Zinc oxide cream is over the counter btw...but always good to get more info first, e.g. from your pharmacist. I too like arnica cream.

I'm sorry you still have your track marks, grid and some redness.

Another suggestion I have: "Sateen" pillow cases. They are far less abrasive to the face and don't suck out moisture like even the finest cottons do.

I did get a scar once from laser (on my hands), but that patch had gotten infected, so I'm remaining optimistic for you!

Good luck!

Hi What is Beauty,

Are your visible veins on your face or hands? are they broken/spider veins, or visible veins? I had some broken spider veins on my face and the Sciton BBL seems to have improved them. I had the spider veins on my thighs (pregnancy) and did schlerotherapy. I also had just a few visible veins on my hands and schlerotherapy helped there - did it 6 years ago or so. But you can only do a couple as scherlotherapy shuts down the vein and you need the blood flow.

RF-
I also am wary of heating up the skin gizmos as you call them. And I would personally never apply RF anywhere there were visible veins.

For a lot of folks RF is just fine, but there is always a risk of fat loss. (Exilis made the same promise of no fat loss due to there improved controls and they also had issues). I get the 'theory' that the energy is only applied to the skin to a certain depth...

Again, for skin tightening on the thighs or stomach, or under-eyes if you have fat bags, that 'risk' becomes a positive. And I have no doubt that many people won't get any fat loss. It's all about risk tolerance. To me, above a certain age, fat loss is worse than scars.

Thanks so much for your good wishes.

I feel compelled to make sure of the accuracy of this thread. The Infini was FDA approved about mid 2013. I've been using it almost since it was available in the states in September 2013. I have performed about 1000 procedures in my office. I have trained dozens of physicians and have lectured all over the country about this technology. Our experience has shown the redness to last about 24-48 hours and then it's minimal. Anything longer than that is not the norm and has not occurred in our office. I have been asked by other physicians as to why this occurred to them and it's hard for me to know the reason. It seems that the settings were appropriate. Could it be technique...maybe. Could it be the creams placed on after the procedure...maybe. If it were to happen to my patients, I would offer a topical steroid or IPL/vascular laser treatment for the reds. Prolonged redness should be treated if lasting more than a couple weeks.

By the way, this is RF so we don't restrict sun exposure or exercise after the procedure. My wife went to yoga within an hour of the procedure (5pm) and ran the following morning before working that day.

We use creams with human growth factors, such as SkinMedica TNS Essential or Lifeline Stem Cell creams after the procedure. I don't think docs use Human Growth Hormone, this is an injection used for antiaging and not used topically normally.

The skin thickness is variable throughout the face. The goal of the Infini is to stay in the dermis to get maximal skin tightening and improve collagen stimulation. The needles can be changed from depths of 0.1mm to 3.5mm. If the depth of the needles exceeds the level of the dermis, sub cutaneous fat is at risk. It is essential that the user use appropriate depths for the area of the face/body treated. I believe that fat is treatable in the submental area with deeper depths and along the jawline and we use deeper levels here and higher settings.

I actually help develop protocols for the procedure. The company's official protocols are less aggressive then I do in the office. Most offices do about 3 depths and 3 passes. We will do up to 5 depths in some areas of the face.. Overlap is not nearly as important as it is with lasers. As long as the skin has a chance to cool between passes, it can take the heat from the Infini with significant overlap extremely well. Double pulses and repeatedly treating small areas is the only concern.

If HA filler is placed below the dermis as is done with cannulas, it should not be at risk of being degraded. If it is placed in the dermis, it is at risk as long as it is present. Bellafill, Radiesse, and probably Sculptra are not at all affected by the Infini because the heat is not hot enough to affect them.

Results on my patients begin to be seen at 3 weeks and continue for at least a few months.

For acne scarring, this seems to be the best treatment I have seen. I have used CO2, Fraxel, microneedling, TCA cross, and none have gotten results that match Infini. Deeper scars should be filled with Bellafill too. Why is Infini better. It is proposed that Infini can get deeper than these other technologies and that elastin is stimulated by the RF and not by any of the others.

There are several articles I have written on Realself that should be referenced. I have blogs that answer just about anything you need to know about Infini.

Hang in there 4ever Young, might just take some time. You seem very up on self care and how treatment responses can vary, so fingers crossed things start to come together over the next few weeks. Started zinc oxide for redness per your recommendation and think I'm noticing a difference finally so thanks again. I see my doc this coming Monday so we'll see what he has to say. Plan to copy some of this thread (don't even know if it's possible) to share info with him, get feedback. Onward!

I've been thinking about your post here. It sounds like your direct experience has been 100% positive and only 1-2 days of noticeable 'downtime' It also sounds like you train other doctors, who did occasionally get this extended redness/swelling reaction, and still felt their settings were okay due to your training and their feedback.

One diagnostic would be for you to use the machine of a doctor that is having this reaction for a time yourself on your own patients, ie swap machines for a month. This would at least rule out manufacturing variation (small defects or differences) or inconsistent machine calibration.

We know with 100% certainty, that regardless of quality control, there can be variations in any product.

Since you are such a big proponent, it would allow you to put your name on the product with greater confidence that went beyond your machine and your own execution. And if you truly have confidence in machine consistency, it shouldn't make you nervous to use their machines on your own patients.

I have had terrific success with multiple treatments (BBL, microneedling, Coolaser/CoolFrax) But aside from the redness/swelling - which I personally don't care about if it can be planned for - if there is excess energy applied with Infini-RF for whatever reason, the fat loss can absolutely be an outcome too. The whole basis for the 'no fat loss' is precise energy control.

I would say it was just different patient reactions, but if you have done 1000 patients, and have gone as aggressive as you say - extra rounds and depth, and not one had extended redness/swelling, then you should have critical mass for a Gaussian distribution (bell curve) that would account for such outliers.

So there is an excellent chance that it's either a machine issue. Or some subtle implementation issue.

I know for sure with Exilis RF that when the aesthetician's mind would wander when doing my thighs, she would repeat the area for longer than appropriate. Given heat is involved and can build up with RF, even for Infini-RF, it requires meticulous attention to not repeating unnecessary passes.

I will say that my doctor for Infini-RF was paying full attention and wasn't repeating strokes unnecessarily - I was paying attention to what he was doing. And I took daily photos to send to him - he was great at follow-up - so my extended downtime was well documented. (I'm not sharing them beyond my doctor to retain my anonymity)

1. I'd have no problem with using other machines. I've used 3 different handpieces on my machine and used 2 other machines in different offices and had similar outcomes. There is no calibration system with this device. However, the variables that could account for differences would be the disposable needle tips. If it were tips as the problem, it should have been evident in the cases so I don't think that is the issue. My experience has shown that an extremely wide range of settings has been safe in my patients. Also, prolonged redness, a minor side effect, doesn't occur in a majority of patients in the docs that asked me about it. My most likely cause is that the topicals placed cause an irritation to the skin. These topicals aren't made to penetrate the skin to the depths which they do right after Infini. They get absorbed over 50x then they normally do on intact skin. Even if the active ingredients are ok at this level and concentration, the carriers are probably the culprit of skin irritation and prolonged redness. Also, sterile technique is absolutely needed. We are creating channels in the skin that normally protects us, and we need to respect the ability of bacteria to traverse these. So, just as in a car accident, there is never one driver that is 100% to blame, I feel that there are some many variables leading to proper outcomes from this procedure/device, that the Infini can only be partly to blame, if at all, for prolonged swellng and redness.
2. You can't compare Exilis to Infini. It's the point of my blogs and lectures. There is no control of depth or exactly where the heat is going with the Exilis. Heat is being pushed through the skin using bulk heating. This is not fractional as the Infini is which has been proven safer in this and other technologies. How deep and to what temperature the deeper dermis is getting is all a big question mark with Exilis.
3. You are the first to describe fat loss of all the patients treated that I know of. The fat loss is in an area that fillers can't treat, in the very upper tear trough? If this is the case, this isn't an area treated with the Infini. It would be extremely unlikely to get loss of fat in area that wasn't treated directly.
4. Histologically, the area of coagulation is very small. It doesn't spread very much from the needles. That is why over treating is very difficult. In fact, recent histology has shown that increasing treatment level (energy) might actually lead to smaller areas of coagulation because the tissue that is heated becomes desiccated very rapidly and prevents further spread of heat. Repeated passes doesn't seem to cause over treatment because of the small coagulation zones. I have treated 10 passes without prolonged redness or side effects and there are others that do the same.
5. As you have said, although some people have said the redness lasts longer than the company and I promote, this tends to resolve without incidence. In addition, people's perception of redness is very different. So to declare a time period for "down time" is really very subjective.

My doctor did treat the area with Infini-RF. He pulled down my lower lid area so that the skin just above the tear trough could also be treated -- he kept it over the bone to protect my eyes. In identical lighting, I now have hollows/shadows that I didn't have in that area. (the skin is still light colored, it's just a hollow)

I also lost fat in my cheek following Infini-fractional - the dent is visible.

I have no issue with prolonged redness; I strongly recommend that the claim that 'downtime is 24-48 hours', be modified to 'usually only 24-48, however, it can be longer in some cases'. Lutronic should understand that it helps their credibility to be straight. Builds trust.

e.g. there is no way someone could go to an office looking as I did for 5 days - the red balloon affect. (To his credit, my doctor DID warn me that the downtime could be longer, so I was prepared)

As for topicals, I agree they are a factor. I have successfully done DIY needling off and on for years, so I'm very aware which topicals can prolong redness through trial and error. Add to that the double whammy of Infini = needles + RF and you have to be even more careful.

The only topical my Dr. applied was Regenica "post procedure" It has been shown to accelerate heading with laser - his judgment seems sound to me – and it didn’t sting at all. After that I only used hyaluronic acid to keep it moist. My skin was still like a red balloon for 5 days.

My goal here is to map in reality vs science/theory. Exilis claimed to solve the fat loss issue and look what happened there. The only way we will truly know what frequency some of these negative results with Lutronic is to:

- have the technology used over a wider patient base over a longer time period
- folks posting 'as they go' who went to many different doctors, vs only after a successful outcome.

It is virtually always the case on RealSelf that a newer technology has higher ratings in the early days, which drop over time as more folks try it out.

I have zero doubt that there will be many successes - my doctor is also excited about its potential.

If one year from now, we get many more folks posting on Infini-RF in real-time, not just after a successful result, and I'm the only one posting here with any fat loss, then it will be clear to all that it's a rare case - and extremely unlikely to happen to them. I actually hope that is the case.

Further, I've have great results with other treatments for scarring/texture and would LOVE a treatment that did tightening while keep skin texture intact. My fingers are crossed for my hands post Infini-RF; laser worked extremely well on my scars, but not on my hands.

I will do an update when I see some change.

Regenica is a great product but I have no experience using it in the situation after Infini where there are small channels in the skin. I'm fairly convinced that prolonged redness is the result of products placed post procedure.

I think pictures are an important part of the aesthetics industry. The patients/public demand the docs and industry show before and after photos of procedures they promote. Slightest changes in lightening or angles are criticized by patients. Obviously millions are spent in research by companies and hundreds of thousands are spent by physicians on these devices. I think it is imperative to see pictures of issues that are claimed to be negative. I don't think it is fair for the Docs and Industry to be held to a different standard. Photographs would be greatly appreciated.

Regarding products placed after the procedure. It is well known that products alone (in intact skin) can cause redness in some patients. The unknown is what happens when it is put into a layer of the skin that it is not supposed to be in. It is very possible that people have a different reaction to products when placed on intact skin vs treated skin. I'm not saying that the procedure isn't red creating but don't think that usual products that a person routinely use are innocuous.

Then perhaps you/Lutronic could give providers guidance on what are safest, effective topicals after a treatment. Without aftercare information good results may be at risk. I've had to experiment for 2+ weeks before settling on a mix of emollient (my doc's brand), TNS and a drop of arnica oil. I keep hair away from my face. Sunscreen as needed. I still have redness on my cheeks 5 weeks out. Give providers information they appear to need about good aftercare products and practices.

Hi Smacpt53,

Very sorry to hear you still have cheek redness 5 weeks out. I truly hope that you are at least seeing gradual improvement.

BTW I looked up TNS serum and it and Regenica repair both have Human Fibroblast Conditioned Media as an ingredient. Yours also has Arbutin for lightening, smart.

I truly wish you the best!

Prolonged redness should be treated with VBeam or Excel V laser.

I've always thought it was the energy difference, just didn't know if it was the machine variation or a difference in settings (you commented that some doctors you trained used your settings and still saw more redness).

I am seeing my doctor tomorrow. He has been following this thread and hopes to contact you before his and I speak to see if there are potential differences in settings, because as I mentioned his experience with inflammation is very different from yours.

Mine reaction was the strongest but he says he has gotten a long red inflammation period with others also.

I do hope it's the settings and not machine manufacturing variances.

I will still remain completely anonymous - and my private maintained.

lots of typos, was speed typing
before he and I speak (not his)
My reaction, (not mine)

Good luck, hope the conversation is fruitful for all.

I can represent infection (including yeast) or sensitivity to topicals,

Festoons are a tough bird to treat with any method. I would at least try Infini. My patients have had mild improvements, not a home run. But nothing is great for these.

Yes, I have tried almost everything to get rid of them. I will start with two treatments as recommended by my doctor to see if the condition improves. Thanks for taking the time to repply Dr. Weiner.

It's an easy 5-10 min procedure. Expect edema of the malar bags for up to a week or so

Dr Adler is a great doc and he has a tremendous Infini experience. Either he or I are largest users in the world.

Wow I learned about that fact in RealSelf thanks to you Dr. Weiner! Dr. Adler is very humble and I have never heard him talk about that. I hope Infini can help me with this condition that has bothered me since my late twenties. I would try to post a review about my experience with Infini with some photos although I am not sure if it will solve my problem. In your experience do you think Infini would be more aggressive in festoons treatment that lasers?

Festoons need the deeper treatment which Infini offers over lasers. Infini will give a better result.

Yes, Infini was Dr. Adler's recommendation. Thank you so much Dr. Weiner for your time and kind attention. I will keep the community informed about my results with Infini. Hope it will give me the improvement I am looking for. Have a wonderful day!

My goal for this thread is to track my *progress*. Instead I’m spending far more time trying to respond to your denials that Lutronic Infini is not 100% perfect on 100% of the people 100% of the time, for 100% of the doctors using it.

You seem to want a 100% positive thread. That simply is not possible over time.

I would request that you would please just leave me alone so I can go back to my progress thread. I actually have full-time work to do also, and family to attend to.

The claims are of fat loss, which has never been seen in our office or shared with me from other physicians. The title of your thread was changed to "highlight" this. I've asked for pictures to see for myself. I don't mind if you send them via email to me so they are not on RealSelf.
I have, and still maintain, that hands are not a great area for the Infini. Filler and laser resurfacing are better. Recovery for hands with all treatments is much longer than face. Redness, even if prolonged, resolves without treatment.
I don't know where I can post, but I have 2 patients with the progression of their recovery/redness over 1-2 days.
I want the thread to remain factual and informative.

>>I want the thread to remain factual and informative.

This is exactly my point. Once again, you imply I must be giving out information that is faulty/not factual – when it’s not what you want to hear and you *claim* you haven't experienced it. Just like all the Q&A answers which told other posters that their result was not possible with Infini.

It appears we have a mutual distrust.

Yes, I highlight my fat loss because that is HUGE. And unlike redness which resolves, it does not.

It breaks my heart to look in the mirror and see how tired and more aged I look now. At a holiday party I looked in the mirror and was shocked and horrified at my under eye hollows – which were much worse in top down lighting, vs my more flattering lighting in my house where I can still see them. (And this is independent of my thinner face and my cheek dent – simply because I don’t know that I can fix it at any cost).

The fat loss actually makes me want to cry - but I've kept that out of this until now because I have been trying to stick to facts only not my personal feelings.

RealSelf is not a propaganda promotion board and you don’t own it. I don't have to prove anything to you personally, especially since for everything that I say (and other posters in the Q&A), you have come up with some reason why it must ‘not be due to the Infini’. In case of my photos you would simply claim it 'must be the lighting' – which of course can be manipulated.

As I mentioned, I am not posting on your own patients’ squeaky clean positive threads (or other doctors’ Infini threads), the fact that because you and the other doctors likely asked them to post AFTER their successful result, it’s a filtered sampling so their input is not statistically representative.

Instead of trying to silence me on my thread, you could be trying to investigate with Lutronic:

1. Why at least one doctor (mine) is getting such inflamed results with Infini that he indicated that oral prednisone would be likely in ADVANCE of my treatment. It is absolutely possible that the same machine irregularity (if that is what it is) that gave me 5 days of a red balloon face (even with 2 days of oral prednisone) was enough to cause the fat loss that you ‘hadn’t seen before’. (Let alone the doctors who told you their own experience redness was longer.)

2. Work with Infini to go beyond their controlled clinical trials and your expert experience, to survey ALL the current doctors using it to have them track the downtime of every patient for 1 month, and if any have experienced fat loss. If yes, are they the same patients that had unusually inflamed and long lasting down time as I did.

I'm sorry if this has happened. Sculptra, Bellafill, or fat can correct any volume deficit. I've tried to give suggestions, hypothesis', and my experience. It appears that they are not appreciated. I will not get into tit for tat. Please report adverse results to Lutronic.

Dr. Weiner,I think your fantastic

I appreciate your expertise.

I've done about 1000 treatments (number of patients is less because of multiple treatments per patient). They are trained by either an RN or Nurse Practitioner. They have the option of coming to my office for further training. There are standard protocols from the company. Parameters aren't the sole cause of redness. I've spoken to docs using appropriate settings and that have gotten swelling. (One was because the topical wasn't wiped off thoroughly and was "pushed" into the skin deeper than it was intended for.) Usually it can be traced to something, but not always. As previously stated: technique, sterility, choice of topicals, post procedure positioning (you must sleep upright for a couple days as much as possible). There is clear guidance from the company. This is not new technology. This is about 3 years old in Korea/Australia and 2.5 years in the states. It is clearly significantly abnormal to be swollen before leaving office "like a balloon" as was stated in this thread. From what I've heard, outcomes are not affected by redness or swelling. We often do 2 or 3 in a day. The most "side effect" we've seen is bruising, which I treat with my Excel V laser within the first couple days.

A condition called angioedema is when trauma, as what happens with Infini or injections, can cause rapid progression of edema. The reason it is occurs is often unknown, but the known causes are ACE inhibitors (a form of blood pressure med), familial, and several other medications. It usually responds quickly to steroids. This is often recurrent in the susceptible patient. In my experience it almost always is associated with ACE inhibitors and stopping them will make the risk lower but you are still susceptible to AE years after stopping the drug. If you are susceptible to this, pre treating with steroids does help. For more severe cases, adding FFP and other blood factors helps decrease the risk. I think this is a real possibility for the case mentioned. This is not dependent on the operator, topical, technique, or settings. During residency, I saw dozens of these cases at The Johns Hopkins Hospital. The key is to recognize the problem early and treat immediately with steroids, high dose decadron IM or IV, not PO, orally.

Well, you and Lutronic now know of one instance (mine) where the impact of the overswelling may indeed have also been correlated with something in the machine causing a long term impact - ie fat loss.

I am in top health with low blood pressure; no meds, never have taken them. My face was like a balloon *before* they put on the Regenica topical, which felt great with no stinging (as I mentioned, I've done needling, so am very tuned to trying a topical out right afterward and rinsing it off because it make my face sting.

I did take Predisone as I left the office and the following day. Never done steroids following a treatment, never needed it.

I just scrolled through photos in my daily texts to my doctor on my Infini RFand it wasn't until day 7 that my face was a normal shape and the color was just a bit pink.

On my FACE, I've done needling, Exilis RF, ablative laser and fractional laser . The Exilis RF edema/redness was gone within an hour (even when I had some fat loss). The needling redness and swelling always gone within 24-48 hours. For fractional CO2 (CoolFrax/Beverley), swelling gone in 24 hrs. For ablative CO2 (Coolaser in Beverly Hills), 8 years ago I did have major swelling, but it was gone in 3 days. (the redness lasted longer and did resolve - redness never concerns me, unless it's a burn). Since then, the Coolaser doctor has tuned his treatment to only 1 day of downtime now. I'm careful about spacing treatments - It had been 1 year since my last Coolazer/CoolFrax on my face.

I just saw two friends I hadn't seen, and each told me I looked tired. (I was well-rested and in full makeup, with light concealer to mask the hollow - as I mentioned, concealer covers darkness in the skin, which I don't have. It doesn't cover hollows.)

I'm now investigating whether fat injections as possible. I don't want to sign up for repeated expensive fillers there for the rest of my life - especially in the eye area.

Wasn't "like a balloon" when I left the office, it developed over 36 hours as I have documented in my photos.

This is what 4ever Young stated and would almost certainly be angioedema if occurred before leaving office. Haven't seen your photos.

I have posted 2 patients showing immediately after Infini and 24 hours later in my gallery. They will be visible in 24-48 hours I expect.

The progessive photos are now up. These are typical recoveries in my hands. The gentleman was actually treated at extremely aggressive settings, more than I customarily do.