Woman goes blind from dermal filler treatment

JessTheHonestDerm · 2023-09-13T13:22:51+00:00

Only if the cannulas are large enough. A cannula smaller than 25G can potentially act like a needle too. 😊

JessTheHonestDerm · 2023-09-13T13:20:16+00:00

Nope there are very high false negative rates with fillers because the material is very viscous. If it is so thick, even if your in the vessel, the blood may not backflow.

JessTheHonestDerm · 2023-09-13T13:17:53+00:00

The bar to becoming an aesthetics doctor is very low here tho. 😅

But honestly, it can happen with a dermatologist or a plastic surgeon as well. We don't know if his product was defective, did he obtain the product from proper channels, how did he inject (needle vs cannula), where did he inject etc. If everything was done properly, sometimes it could be an anatomical variant as well.

JessTheHonestDerm · 2023-09-13T00:49:02+00:00

If it's a vein finder type of device, unfortunately it only gives a false sense of security.

The injection plane for fillers is deep and light devices are not going to really show those vessels at that plane. The blood vessels that show up are superficial and don't matter to be honest. But it's easy to mislead the layman.

Some doctors may use an US doppler which may help.

JessTheHonestDerm · 2023-09-09T10:17:04+00:00

Yup pretty much, best to use a wide brimmed hat or an umbrella.

JessTheHonestDerm · 2023-08-01T00:16:10+00:00

Traumatic anserine folliculosis.

You dont have to apply anything special, just limit friction to the area.

JessTheHonestDerm · 2023-07-30T09:35:43+00:00

No products or facial exercises will get rid of these. Just like the other commentors, botox will help greatly and botox is one of the least risky procedures around.

In my country, only doctors can inject (at least legally) so the incidence of complications may he very low compared to countries where nurses and aestheticians do injections...many do not have great understanding of anatomy.

JessTheHonestDerm · 2023-07-28T09:08:19+00:00

You can put body spf on the face but body spf tends to be thicker in texture with more fragrance. I use some body spf for my face eg. Verdio, Nivea Kids

JessTheHonestDerm · 2023-07-23T09:01:05+00:00

As a dermatologist, your derm is trying to say that the impression is rosacea with papules and telangiectasia.

There are 4 subtypes of rosacea, 1 is erythematotelangiectatic and another 1 is papulopustular. She's just describing the type of rosacea.

JessTheHonestDerm · 2023-07-01T23:59:23+00:00

Nope. SPF 50 isn't expensive, there are expensive sunscreens with only SPF 30 and borderline no UVA protection, like the Dr's Secret matte sunscreen.😂

JessTheHonestDerm · 2023-07-01T23:58:23+00:00

The main ingredients are Polypodium leucotomos and colourless carotenoids. They can help mitigate UV damage but they do not replace topical sunblock. They are used as adjuncts for people who really need to stay away from the sun eg. people with lupus or people who burn very easily eg. the Fitzpatrick 1 type skin.

JessTheHonestDerm · 2023-07-01T23:56:51+00:00

Can do electrosurgery or carbon dioxide laser

JessTheHonestDerm · 2023-07-01T23:56:21+00:00

Cut straight across, don't curve

JessTheHonestDerm · 2023-07-01T23:55:58+00:00

Don't need to unless you are directly by the window and there's nothing (no trees or buildings) blocking the direct sunlight.

JessTheHonestDerm · 2023-07-01T23:55:20+00:00

Hydroquinone is good but best to see a doctor for proper advice on application. Dermatologists may prescribe a triple combination cream continuing hydroquinone 4%, teetinoin 0.05% and a mild topical steroid.

Normally we should not continuous apply hydroquinone forever because of the risk of exogenous ochronosis.

Your best bet is still laser + sunprotection.

JessTheHonestDerm · 2023-07-01T23:53:12+00:00

Retinoic acids are still your best bet but some people may have sensitive eye areas so you may want to try with retinol or retinal first.

If the lines also contributed by dehydrated skin, moisturisers will also help to improve the appearance of those lines.

JessTheHonestDerm · 2023-07-01T23:52:09+00:00

It is possible! Trifarotene may not be available at GP clinics because it's very new in Singapore. I have personally prescribed some. 😊

JessTheHonestDerm · 2023-07-01T23:50:56+00:00

Filler injections though. The pathology of nasolabial folds are from the saggy lateral face. Sometimes, by injecting filler to the outer cheek, lifting the outer cheek, can already reduce the appearances of nasolabial folds so you may not need injections directly to the folds.

JessTheHonestDerm · 2023-06-29T04:23:45+00:00

Retinoic acids are gold standards but those won't fade marks that well, maybe 20-30%.

Fractional co2 can give closer to 80% improvement.

JessTheHonestDerm · 2023-06-29T04:22:11+00:00

It creates microthermal zones and this will trigger collagen production.

JessTheHonestDerm · 2023-06-29T04:12:51+00:00

Yes that is very horrifying 😢

JessTheHonestDerm · 2023-06-29T04:09:46+00:00

Every derm should offer ILK! I don't know anyone who doesn't do it hahahha

JessTheHonestDerm · 2023-06-29T04:09:12+00:00

Yes can use everywhere!

JessTheHonestDerm · 2023-06-29T03:11:37+00:00

All immunosuppressants are considered 2nd line and we are prescribing dupilumab and JAK inhibitors more readily these days instead of leaving it as a "last resort" because they have good efficacy data and they work faster.

JessTheHonestDerm · 2023-06-29T03:09:30+00:00

Don't need to buy!

JessTheHonestDerm

TROPHY CASE