LAM FACIAL PLASTICS

Hi Dr. Lam,

I had Elevess injected into my upper lip 3 weeks ago, and have been miserable ever since.

First, I have had juvederm 3 times prior. Perfect! I have attached a photo of my natural smile, my smile post-juvederm by the good doctor, and my smile and lips post-elevess. I made the mistake of not going to my regular doctor and instead trying a Medspa where I get facials.

They injected nearly the entire syringe (.2cc left) in just my top lip (the most I have EVER had with juvederm is .4 and I told the tech this). My swelling was severe. I went back in 2 days later and the doctor, who did NOT do the injection by the way, saw me, and then went back out and yelled at the tech, saying what did you do to her!? (I could hear through the door). They chalked the severe reaction up to the immense amount of lidocaine she used in the dental block. Needless to say, that swelling subsided, but my smile is lopsided, and there is a bump on the left side. I feel like I look chimp-like, with swelling and puffiness above the sides. What is odd, I still swell in the morning (to the extent where I cannot put my lips over my teeth) and feel hard lumps. By evening it looks better, but still I feel self-conscious about my once-beautiful smile. I called to ask about Vitrase and she informed me that I should just give it 4 months and let it go down. She said I should massage frequently and that will help. I said I would prefer not to wait since I am in a profession where I must give speeches in front of many people and she informed me she would have to specially order the enzyme and she would let me know what her fee would be for this service.

I have attached photos and would like to see if you recommend I come to Dallas to have to you put me back to normal! I can't afford missing work any longer for severe-freak-like swelling (I was hideous for a solid week) so I was wondering what the down-time is for hyaluronidase injections and the risks of doing that, and if you would be willing to inject this in my circumstance. I am in San Antonio.

Thank you,

Sheila

I am sorry to hear of your situation. vitrase should easily reverse the situation. obviously, the only risk of vitrase is that it can dissolve the whole thing so just use very small amounts. i am not going to publish what amounts here because that would not be a medico-legally wise thing to do. (you also should do a skin test before administration, which i am now doing all the time to make sure that there is no allergy, which is pretty darn rare.) the other problem is that i am booked out a few months, and my staff has forbid me to try to squeeze someone in. i think you should be able to find someone in San Antonio that does Vitrase dissolving. To be honest, I am shocked repeatedly that injectors do not stock vitrase as a standard in every office. I would love to see you but I think my schedule simply might not permit. If you really want me to do it (and I would be honored to take care of you), you can put your name on a waiting list with me if you can't find someone in SA to take care of you. i apologize in advance if i can't accommodate you in my schedule.
best,
sml