LAM FACIAL PLASTICS

Hi Dr Lam. About 4 months ago i had Artefill into some wrinkles. It was a $1200 treatment and there was a bunch left over so i had some injected into a small acne scar on my cheek.The scar was really only noticeable to me. Within an hour of treatment my cheek started burning and turned very red. The DR. said vascular occlusion, a 2nd opinion i got thought it was reaction to Artefill. Long story short i was left with a horrible nickel sized scar. The Dr. is treating with Fraxel Restore with little improvement and says i will need more filler eventually. I live in Austin and would have no problem coming to see you. Could you help ?

yes, i should be able to help you. first, i would give it sufficient time like 6 months to see if things restore. however, if you cannot wait (which i would understand) i would use a filler like restylane for a few reasons. first, it is reversible in case the vessel is bothered again. second, in case things change for the better over this year (which it can) then the restylane can be dissolved out. also, i can try this micro cannula technique that virtually eliminates the risk of vascular occlusion but in your case may not be as accurate. i would probably start with that and see what i get. if not, i would switch to a fine needle. i always draw back on the needle but that does not 100% guarantee no vascular issues albeit these are extremely rare. hope to help you.
best
sml

as far as what i can see in the photograph, i do not think a filler would work right now and may worsen things. there is a mottled appearance and uneven texture to the area with only a very small divot. i would personally let this settle for 6 months before touching it if not further. it may need a light IPL like KTP laser or something for the redness but Fraxel restore intuitively does not make sense to me. you might need mechanical dermabrasion to smooth things out later on rather than filling but it is too risky to do that now. i hope you understand that dermabrasion i mean sanding down the skin not just a spa treatment like microderm. just don't know if filling is the right answer based on limited photos at least not now.
best,
sml

Dr. Lam that was just three days after Artefill. It scabbed over and left a huge nickel sized dent. Its 4 months out now and inmproved only slightly. I will let it settle down for a couple more months then come see you. Thanks again.

ok, sounds like a good plan. i should see a more recent photo then.

ok, much better photo. i am glad things healed well for you. looks as if just the filler any time will be fine to do for you. i would probably encourage you to consider just the temporary restylane filler just to be absolutely safe but you are good to go anytime to do it.
best,
sml